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

Michael Marmor1, Sujata Thawani, Maria Luisa Cotrina

  • 1Department of Population Health, NYU Grossman School of Medicine, New York (Dr Marmor, Dr Shao, Ms Wang, Dr Alexander), Department of Environmental Medicine, NYU Grossman School of Medicine, New York, New York (Dr Marmor, Dr Shao, Ms Wang, Dr Reibman), Department of Medicine, NYU Grossman School of Medicine, New York, New York (Dr Marmor, Dr Cotrina, Dr Wilkenfeld, Dr Reibman), Department of Neurology, NYU Grossman School of Medicine, New York, New York (Dr Thawani, Dr Alexander, Dr Wong), Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (Dr Wong), UCSF/Fresno and University Neurology Associates, Fresno, California (Dr Stecker), Division of Occupational and Environmental Medicine, Department of Medicine, NYU Winthrop Hospital, Mineola, New York (Dr Wilkenfeld) and Department of Internal Medicine, Strelitz Diabetes Center, Eastern Virginia Medical School, Norfolk, Virginia (Ms Vinik, Dr Vinik).

Journal of Occupational and Environmental Medicine
|February 13, 2020
PubMed
Summary
This summary is machine-generated.

World Trade Center (WTC) exposure is linked to lower extremity paresthesia and neuropathy. Neuropathy signs were more prevalent in WTC-exposed individuals with paresthesia, indicating a WTC-related risk factor.

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Area of Science:

  • Neurology
  • Environmental Health

Background:

  • Paresthesia (abnormal sensations) in the lower extremities can affect individuals exposed to the World Trade Center (WTC) disaster.
  • The underlying causes of WTC-related paresthesia require investigation, including potential neuropathy, metabolic issues, or neurotoxin exposure.

Purpose of the Study:

  • To determine if paresthesia in WTC-exposed individuals is associated with neurological signs, metabolic abnormalities, or neurotoxin exposures.
  • To differentiate WTC-related causes from other potential etiologies of paresthesia.

Main Methods:

  • A case-control study design was employed.
  • Cases comprised WTC-exposed individuals with paresthesia.
  • Controls included WTC-exposed individuals without paresthesia (clinic controls) and WTC-unexposed individuals (community controls).

Main Results:

  • WTC-exposed cases with paresthesia exhibited significantly worse neurological findings compared to controls.
  • Reduced intraepidermal nerve fiber density and abnormal sural to radial sensory nerve amplitude ratios were observed in cases, indicating small and large fiber neuropathy.
  • Neurologic abnormalities were rare in WTC-unexposed community controls, and metabolic conditions or neurotoxin exposures did not differ between groups.

Conclusions:

  • WTC-related paresthesia is associated with objective signs of small and large fiber neuropathy.
  • WTC exposures are supported as risk factors for developing neuropathy.
  • Non-WTC etiologies were not supported as the primary cause for these symptoms.