The long-term effects of occupational exposure to vinyl chloride monomer on microcirculation: a cross-sectional study 15 years after retirement
Identifieur interne : 004439 ( Main/Exploration ); précédent : 004438; suivant : 004440The long-term effects of occupational exposure to vinyl chloride monomer on microcirculation: a cross-sectional study 15 years after retirement
Auteurs : Vincent Lopez [France] ; Alain Chamoux [France] ; Marion Tempier [France] ; Hélène Thiel [France] ; Sylvie Ughetto [France] ; Marion Trousselard [France] ; Geraldine Naughton [Australie] ; Frédéric Dutheil [France, Australie]Source :
- BMJ Open [ 2044-6055 ] ; 2013.
Abstract
To assess residual long-term microcirculation abnormalities by capillaroscopy, 15 years after retiring from occupational exposure to vinyl chloride monomer (VCM).
Cross-sectional study.
Allier, one of the major areas of polyvinyl chloride production in France.
We screened 761 (97% men) retired workers exposed to chemical toxics. Exposure to chemicals other than VCM excluded potential participants.
These participants underwent a medical examination including a capillaroscopy, symptoms of Raynaud and comorbidities, as well as a survey to determine exposure time, direct or indirect contact, type of occupation, smoking status and time after exposure. A double blind analysis of capillaroscopic images was carried out. A control group was matched in age, sex, type of occupation.
179/761 retired workers were only exposed to VCM at their work, with 21 meeting the inclusion criteria and included. Exposure time was 29.8±1.9 years and time after exposure was 15.9±2.4 years. Retired workers previously exposed to VCM had significantly higher capillaroscopic modifications than the 35 controls: enlarged capillaries (19% vs 0%, p<0.001), dystrophy (28.6% vs 0%, p=0.0012) and augmented length (33% vs 0%, p<0.001). Time exposure was linked (p<0.001) with enlarged capillaries (R2=0.63), dystrophy (R2=0.51) and capillary length (R2=0.36). They also had higher symptoms of Raynaud (19% vs 0%, p=0.007) without correlation with capillaroscopic modifications.
Although VCM exposure was already known to affect microcirculation, our study demonstrates residual long-term abnormalities following an average of 15 years’ retirement, with a time-related exposure response. Symptoms of Raynaud, although statistically associated with exposure, were not related to capillaroscopic modifications; its origin remains to be determined.
Url:
DOI: 10.1136/bmjopen-2013-002785
PubMed: 23794583
PubMed Central: 3686170
Affiliations:
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Montpied</institution>,<addr-line>Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af6"><institution>School of Exercise Science, Australian Catholic University</institution>,<addr-line>Fitzroy</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Blaise Pascal University, Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23794583</idno><idno type="pmc">3686170</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686170</idno><idno type="RBID">PMC:3686170</idno><idno type="doi">10.1136/bmjopen-2013-002785</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002310</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002310</idno><idno type="wicri:Area/Pmc/Curation">002160</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002160</idno><idno type="wicri:Area/Pmc/Checkpoint">001834</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001834</idno><idno type="wicri:Area/Ncbi/Merge">001327</idno><idno type="wicri:Area/Ncbi/Curation">001327</idno><idno type="wicri:Area/Ncbi/Checkpoint">001327</idno><idno type="wicri:Area/Main/Merge">004521</idno><idno type="wicri:Area/Main/Curation">004439</idno><idno type="wicri:Area/Main/Exploration">004439</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The long-term effects of occupational exposure to vinyl chloride monomer on microcirculation: a cross-sectional study 15 years after retirement</title><author><name sortKey="Lopez, Vincent" sort="Lopez, Vincent" uniqKey="Lopez V" first="Vincent" last="Lopez">Vincent Lopez</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Occupational Medicine</addr-line>,<institution>University Hospital CHU G. Montpied</institution>,<addr-line>Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chamoux, Alain" sort="Chamoux, Alain" uniqKey="Chamoux A" first="Alain" last="Chamoux">Alain Chamoux</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Occupational Medicine</addr-line>,<institution>University Hospital CHU G. Montpied</institution>,<addr-line>Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Tempier, Marion" sort="Tempier, Marion" uniqKey="Tempier M" first="Marion" last="Tempier">Marion Tempier</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Radiopharmacy</addr-line>,<institution>University Hospital CHU G. Montpied</institution>,<addr-line>Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Thiel, Helene" sort="Thiel, Helene" uniqKey="Thiel H" first="Hélène" last="Thiel">Hélène Thiel</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Vascular Medicine</addr-line>,<institution>University Hospital CHU G. Montpied</institution>,<addr-line>Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ughetto, Sylvie" sort="Ughetto, Sylvie" uniqKey="Ughetto S" first="Sylvie" last="Ughetto">Sylvie Ughetto</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Medical Information—Clinical research and innovation direction</addr-line>,<institution>University Hospital CHU G. Montpied</institution>,<addr-line>Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Trousselard, Marion" sort="Trousselard, Marion" uniqKey="Trousselard M" first="Marion" last="Trousselard">Marion Trousselard</name><affiliation wicri:level="1"><nlm:aff id="af5"><addr-line>Neurophysiology of emotions, ENOP Department</addr-line>,<institution>CRSSA/IRBA</institution>,<addr-line>La Tronche</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Naughton, Geraldine" sort="Naughton, Geraldine" uniqKey="Naughton G" first="Geraldine" last="Naughton">Geraldine Naughton</name><affiliation wicri:level="1"><nlm:aff id="af6"><institution>School of Exercise Science, Australian Catholic University</institution>,<addr-line>Fitzroy</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dutheil, Frederic" sort="Dutheil, Frederic" uniqKey="Dutheil F" first="Frédéric" last="Dutheil">Frédéric Dutheil</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Occupational Medicine</addr-line>,<institution>University Hospital CHU G. Montpied</institution>,<addr-line>Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af6"><institution>School of Exercise Science, Australian Catholic University</institution>,<addr-line>Fitzroy</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Blaise Pascal University, Clermont-Ferrand</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>To assess residual long-term microcirculation abnormalities by capillaroscopy, 15 years after retiring from occupational exposure to vinyl chloride monomer (VCM).</p></sec><sec><title>Design</title><p>Cross-sectional study.</p></sec><sec><title>Setting</title><p>Allier, one of the major areas of polyvinyl chloride production in France.</p></sec><sec><title>Participants</title><p>We screened 761 (97% men) retired workers exposed to chemical toxics. Exposure to chemicals other than VCM excluded potential participants.</p></sec><sec><title>Primary and secondary outcome measures</title><p>These participants underwent a medical examination including a capillaroscopy, symptoms of Raynaud and comorbidities, as well as a survey to determine exposure time, direct or indirect contact, type of occupation, smoking status and time after exposure. A double blind analysis of capillaroscopic images was carried out. A control group was matched in age, sex, type of occupation.</p></sec><sec><title>Results</title><p>179/761 retired workers were only exposed to VCM at their work, with 21 meeting the inclusion criteria and included. Exposure time was 29.8±1.9 years and time after exposure was 15.9±2.4 years. Retired workers previously exposed to VCM had significantly higher capillaroscopic modifications than the 35 controls: enlarged capillaries (19% vs 0%, p<0.001), dystrophy (28.6% vs 0%, p=0.0012) and augmented length (33% vs 0%, p<0.001). Time exposure was linked (p<0.001) with enlarged capillaries (R<sup>2</sup>=0.63), dystrophy (R<sup>2</sup>=0.51) and capillary length (R<sup>2</sup>=0.36). They also had higher symptoms of Raynaud (19% vs 0%, p=0.007) without correlation with capillaroscopic modifications.</p></sec><sec><title>Conclusions</title><p>Although VCM exposure was already known to affect microcirculation, our study demonstrates residual long-term abnormalities following an average of 15 years’ retirement, with a time-related exposure response. Symptoms of Raynaud, although statistically associated with exposure, were not related to capillaroscopic modifications; its origin remains to be determined.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Allsopp, M" uniqKey="Allsopp M">M Allsopp</name></author><author><name sortKey="Giovanni, G" uniqKey="Giovanni G">G Giovanni</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fontana, L" uniqKey="Fontana L">L Fontana</name></author><author><name sortKey="Baietto, M" uniqKey="Baietto M">M Baietto</name></author><author><name sortKey="Becker, F" uniqKey="Becker F">F Becker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Veltman, G" uniqKey="Veltman G">G Veltman</name></author><author><name sortKey="Lange, Ce" uniqKey="Lange C">CE Lange</name></author><author><name sortKey="Juhe, S" uniqKey="Juhe S">S 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uniqKey="Mortimer P">PS Mortimer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bonacci, E" uniqKey="Bonacci E">E Bonacci</name></author><author><name sortKey="Santacroce, N" uniqKey="Santacroce N">N Santacroce</name></author><author><name sortKey="D Amico, N" uniqKey="D Amico N">N D'Amico</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Antonios, Tf" uniqKey="Antonios T">TF Antonios</name></author><author><name sortKey="Singer, Dr" uniqKey="Singer D">DR Singer</name></author><author><name sortKey="Markandu, Nd" uniqKey="Markandu N">ND Markandu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lehr, Ha" uniqKey="Lehr H">HA Lehr</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lova, Rm" uniqKey="Lova R">RM Lova</name></author><author><name sortKey="Miniati, B" uniqKey="Miniati B">B Miniati</name></author><author><name sortKey="Macchi, C" uniqKey="Macchi C">C Macchi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Betta, A" uniqKey="Betta A">A Betta</name></author><author><name sortKey="Tommasini, M" uniqKey="Tommasini M">M Tommasini</name></author><author><name sortKey="Bovenzi, M" uniqKey="Bovenzi M">M Bovenzi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ostlere, Ls" uniqKey="Ostlere L">LS Ostlere</name></author><author><name sortKey="Harris, D" uniqKey="Harris D">D Harris</name></author><author><name sortKey="Buckley, C" uniqKey="Buckley C">C Buckley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Block, Ja" uniqKey="Block J">JA Block</name></author><author><name sortKey="Sequeira, W" uniqKey="Sequeira W">W Sequeira</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Herrick, Al" uniqKey="Herrick A">AL Herrick</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koischwitz, D" uniqKey="Koischwitz D">D Koischwitz</name></author><author><name sortKey="Marsteller, Hj" uniqKey="Marsteller H">HJ Marsteller</name></author><author><name sortKey="Lackner, K" uniqKey="Lackner K">K Lackner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dutheil, F" uniqKey="Dutheil F">F Dutheil</name></author><author><name sortKey="Kelly, C" uniqKey="Kelly C">C Kelly</name></author><author><name sortKey="Biat, I" uniqKey="Biat I">I Biat</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chiew, M" uniqKey="Chiew M">M Chiew</name></author><author><name sortKey="Weber, Mf" uniqKey="Weber M">MF Weber</name></author><author><name sortKey="Egger, S" uniqKey="Egger S">S Egger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Penfornis, A" uniqKey="Penfornis A">A Penfornis</name></author><author><name sortKey="San Galli, F" uniqKey="San Galli F">F San-Galli</name></author><author><name sortKey="Cimino, L" uniqKey="Cimino L">L Cimino</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Heinavaara, S" uniqKey="Heinavaara S">S Heinavaara</name></author><author><name sortKey="Tokola, K" uniqKey="Tokola K">K Tokola</name></author><author><name sortKey="Kurttio, P" uniqKey="Kurttio P">P Kurttio</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eriksen, L" uniqKey="Eriksen L">L Eriksen</name></author><author><name sortKey="Gronbaek, M" uniqKey="Gronbaek M">M Gronbaek</name></author><author><name sortKey="Helge, Jw" uniqKey="Helge J">JW Helge</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li><li>France</li></country></list><tree><country name="France"><noRegion><name sortKey="Lopez, Vincent" sort="Lopez, Vincent" uniqKey="Lopez V" first="Vincent" last="Lopez">Vincent Lopez</name></noRegion><name sortKey="Chamoux, Alain" sort="Chamoux, Alain" uniqKey="Chamoux A" first="Alain" last="Chamoux">Alain Chamoux</name><name sortKey="Dutheil, Frederic" sort="Dutheil, Frederic" uniqKey="Dutheil F" first="Frédéric" last="Dutheil">Frédéric Dutheil</name><name sortKey="Dutheil, Frederic" sort="Dutheil, Frederic" uniqKey="Dutheil F" first="Frédéric" last="Dutheil">Frédéric Dutheil</name><name sortKey="Tempier, Marion" sort="Tempier, Marion" uniqKey="Tempier M" first="Marion" last="Tempier">Marion Tempier</name><name sortKey="Thiel, Helene" sort="Thiel, Helene" uniqKey="Thiel H" first="Hélène" last="Thiel">Hélène Thiel</name><name sortKey="Trousselard, Marion" sort="Trousselard, Marion" uniqKey="Trousselard M" first="Marion" last="Trousselard">Marion Trousselard</name><name sortKey="Ughetto, Sylvie" sort="Ughetto, Sylvie" uniqKey="Ughetto S" first="Sylvie" last="Ughetto">Sylvie Ughetto</name></country><country name="Australie"><noRegion><name sortKey="Naughton, Geraldine" sort="Naughton, Geraldine" uniqKey="Naughton G" first="Geraldine" last="Naughton">Geraldine Naughton</name></noRegion><name sortKey="Dutheil, Frederic" sort="Dutheil, Frederic" uniqKey="Dutheil F" first="Frédéric" last="Dutheil">Frédéric Dutheil</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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