Case-Control Study of Paresthesia among World Trade Center-Exposed Community Members

Michael Marmor; Sujata Thawani; Maria Luisa Cotrina; Yongzhao Shao; Ericka S. Wong; Mark M. Stecker; Bin Wang; Alexander Allen; Marc Wilkenfeld; Etta J. Vinik; Aaron I. Vinik; Joan Reibman

doi:10.1097/JOM.0000000000001828

Case-Control Study of Paresthesia among World Trade Center-Exposed Community Members

Michael Marmor, Sujata Thawani, Maria Luisa Cotrina, Yongzhao Shao, Ericka S. Wong, Mark M. Stecker, Bin Wang, Alexander Allen, Marc Wilkenfeld, Etta J. Vinik, Aaron I. Vinik, Joan Reibman

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	307-316
Number of pages	10
Journal	Journal of Occupational and Environmental Medicine
Volume	62
Issue number	4
DOIs	https://doi.org/10.1097/JOM.0000000000001828
State	Published - 1 Apr 2020
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2019 American College of Occupational and Environmental Medicine.

Keywords

electrodiagnostic neurologic measurements
neuropathic symptoms
paresthesia
peripheral neuropathy
small nerve fiber density

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

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10.1097/JOM.0000000000001828

Cite this

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title = "Case-Control Study of Paresthesia among World Trade Center-Exposed Community Members",

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.",

keywords = "electrodiagnostic neurologic measurements, neuropathic symptoms, paresthesia, peripheral neuropathy, small nerve fiber density",

author = "Michael Marmor and Sujata Thawani and Cotrina, {Maria Luisa} and Yongzhao Shao and Wong, {Ericka S.} and Stecker, {Mark M.} and Bin Wang and Alexander Allen and Marc Wilkenfeld and Vinik, {Etta J.} and Vinik, {Aaron I.} and Joan Reibman",

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year = "2020",

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doi = "10.1097/JOM.0000000000001828",

language = "English",

volume = "62",

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T1 - Case-Control Study of Paresthesia among World Trade Center-Exposed Community Members

AU - Marmor, Michael

AU - Thawani, Sujata

AU - Cotrina, Maria Luisa

AU - Shao, Yongzhao

AU - Wong, Ericka S.

AU - Stecker, Mark M.

AU - Wang, Bin

AU - Allen, Alexander

AU - Wilkenfeld, Marc

AU - Vinik, Etta J.

AU - Vinik, Aaron I.

AU - Reibman, Joan

PY - 2020/4/1

Y1 - 2020/4/1

N2 - 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.

AB - 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.

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KW - small nerve fiber density

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Case-Control Study of Paresthesia among World Trade Center-Exposed Community Members

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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