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Patel BA, Townsley DM, Scheinberg P. Immunosuppressive therapy in severe aplastic anemia. Semin Hematol 2022; 59:21-29. [DOI: 10.1053/j.seminhematol.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/11/2022]
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Syed MA, Rahman AAU, Ghani A, Shah Syed MN, Siddiqui MI, Riaz H, Khidri FF, Baloch NN. An Investigation of Selected Socio-Demographic Factors with Aplastic Anemia in Pakistan: A Case-Control Study. Int J Gen Med 2021; 14:8929-8934. [PMID: 34876834 PMCID: PMC8642121 DOI: 10.2147/ijgm.s335961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/28/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction In Pakistan, the incidence rate of aplastic anemia is 3.5 cases/million. The associated risk factors are exposure to pesticides, chemicals, and some drugs. The link between aplastic anemia and socio-demographic factors is debatable. Purpose We conducted this study to investigate the role of socio-economic and -demographic factors with aplastic anemia. Methodology A total of 191 lab-confirmed incident cases of aplastic anemia were identified from the tertiary hospital of Karachi-Pakistan in between 2015 and 2018. Age and gender-matched 694 controls were randomly selected from the same institute admitted or visited for other non-neoplastic conditions. Socio-demographic and exposure information was gathered using a data collection form. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were computed for selected socio-demographic factors. Results Among socio-demographic factors, significant associations of aplastic anemia risk emerged for illiteracy (aOR: 2.3; 1.5; 3.5) occupation (any type) (aOR: 2.1; 1.7; 2.5), living in rural environments (aOR: 2.9; 1.9; 4.2). The odds of aplastic anemia increased with the age group 31–50 years (aOR: 1.8; 1.7; 3.5) and >50 years (aOR: 2.5; 2.1; 4.2). We observed no association of income with the risk of aplastic anemia. Conclusion This study highlights the importance of socio-demographic factors as a risk factor for the development of aplastic anemia in the population of Pakistan. In order to reduce disease incidence, health education program and use of personal protective equipment and organization of screening camps in high-risk population is warranted.
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Affiliation(s)
- Muhammad Asif Syed
- Field Epidemiology Laboratory Training Program (FELTP), Karachi, Pakistan
| | - Aneela Atta Ur Rahman
- Department of Community Medicine & Public Health Sciences, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Abdul Ghani
- Department of Health, Jam Ghulam Qadir Government Teaching Hospital, Hub, Pakistan
| | - Muhammad Nadeem Shah Syed
- National Emergency Operation Center, National Stop Transmission of Polio (N-STOP), Islamabad, Pakistan
| | - Muhammad Ilyas Siddiqui
- Department of Community Medicine & Public Health Sciences, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Hina Riaz
- Department of Physiology/Medical Research Centre, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
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Sanyal S, Law S. Chronic pesticide exposure induced aberrant Notch signalling along the visual pathway in a murine model. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 282:117077. [PMID: 33839617 DOI: 10.1016/j.envpol.2021.117077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
Pesticides aid in crop-protection against pests and increase yield. However, the xenobiotic stress exerted by pesticides leads to the deterioration of human and animal health. There is a lacuna in our knowledge about their impact on the ocular surface The present work sheds light on this gap by analysing the deterioration of visual acuity as a consequence of pesticide induced xenobiotic stress and Notch pathway dysregulation. Alteration in the expression of vital components of the notch signalling was analyzed along the visual pathway with special focus on its two terminals-the cornea and the visual cortex, by mimicking the on-field scenario regarding chronic pesticide exposure in experimental murine model (Swiss albino mice; Mus musculus). Various aspects were taken into consideration through visual acuity tests, histological evaluations, culture analyses, wound healing assays, flowcytometric evaluation, fluorescence microscopic studies etc. Complete dysregulation of key players of the Notch signalling pathway was observed in both: cells of the ocular surface as well as those in the murine visual cortex post pesticide exposure, indicating activities relating to cell proliferation, differentiation and wound healing in the pesticide exposed samples. Ultra-microscopic analyses corroborated our findings by revealing the loss of fine neural processes in the visual cortex of the pesticide exposed murine samples, thereby hinting at delayed perception to visual stimuli. In vivo evaluations of the functional capacity of the neuroanatomical structures along the visual pathway also confirmed that pesticide exposure leads to severe damage along the various parts of the visual pathway, right from the ocular surface to the visual cortex.
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Affiliation(s)
- Shalini Sanyal
- Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, India
| | - Sujata Law
- Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, India.
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Asif Syed M, Rahman AAU, Siddiqui MI, Arain AA. Pesticides and Chemicals as Potential Risk Factors of Aplastic Anemia: A Case-Control Study Among a Pakistani Population. Clin Epidemiol 2021; 13:469-475. [PMID: 34168504 PMCID: PMC8219111 DOI: 10.2147/clep.s304132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/13/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction Aplastic anemia is a rare and potentially life-threatening hematological disorder with incidence of 1.4 to 14 cases/million. It is associated with exposures to certain environmental chemicals, drugs and infections. The objective was to investigate the association of illness with family history of aplastic anemia, exposure to pesticides and chemicals. Methodology A hospital-based case–control study (191 cases, 696 controls) was conducted from 1st January 2015 to 31st December 2018 in Karachi, Sindh. Cases were patients with diagnosis of aplastic anemia confirmed with bone marrow biopsy. Controls neither had aplastic anemia nor other hematological chronic diseases. An in-person interview was conducted to collect demographic information, family history of aplastic anemia, and history of pesticide and chemical exposure. The adjusted odds ratios (aOR) with 95% confidence intervals (CI) were estimated via SPSS v22. Results A total of 191 confirmed aplastic anemia cases were selected. Mean age was 29 years (range: 4–69) and predominantly there were males 129 (67.5%). The majority, 84 (44.0%), of the cases were aged 16–30 years. In multivariate analysis models, the significant associations were observed between aplastic anemia with family history of aplastic anemia (aOR=13.3, 95% C.I 3.66–48.50), exposure to pesticides (aOR=2.1, 95% C.I 1.23–3.61) and chemicals (aOR=3.6, 95% C.I 2.06–6.34). Conclusion This study observed a significant association of aplastic anemia with family history of aplastic anemia, exposure to pesticide and insecticide exposure. However, to establish this connection, further longitudinal studies are warranted. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/qPDeSjfZPbo
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Affiliation(s)
| | - Aneela Atta Ur Rahman
- Department of Community Medicine & Public Health Sciences, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Muhammad Ilyas Siddiqui
- Department of Community Medicine & Public Health Sciences, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Ashique Ali Arain
- Department of Pharmacology, Muhammad Medical College, Mirprkhas, Sindh, Pakistan
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Hansen MRH, Jørs E, Sandbæk A, Sekabojja D, Ssempebwa JC, Mubeezi R, Staudacher P, Fuhrimann S, Burdorf A, Bibby BM, Schlünssen V. Exposure to cholinesterase inhibiting insecticides and blood glucose level in a population of Ugandan smallholder farmers. Occup Environ Med 2020; 77:713-720. [PMID: 32632029 PMCID: PMC7509396 DOI: 10.1136/oemed-2020-106439] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/27/2020] [Accepted: 06/06/2020] [Indexed: 12/12/2022]
Abstract
Objectives The risk of diabetes mellitus may be elevated among persons exposed to some pesticides, including cholinesterase-inhibiting insecticides (organophosphates and carbamates). The objective of this study was to investigate how acetylcholinesterase activity was associated with mean blood glucose levels among smallholder farmers in Uganda. Methods We conducted a short-term follow-up study among 364 smallholder farmers in Uganda. Participants were examined three times from September 2018 to February 2019. At each visit, we measured glycosylated haemoglobin A (HbA1c) as a measure of long-term average blood glucose levels. Exposure to organophosphate and carbamate insecticides was quantified using erythrocyte acetylcholinesterase normalised by haemoglobin (AChE/Hb). For a subgroup of participants, fasting plasma glucose (FPG) was also available. We analysed HbA1c and FPG versus AChE/Hb in linear mixed and fixed effect models adjusting for age, sex, physical activity level, and consumption of fruits and vegetables, alcohol and tobacco. Results Contrary to our hypothesis, our mixed effect models showed significant correlation between low AChE/Hb and low HbA1c. Adjusted mean HbA1c was 0.74 (95% CI 0.17 to 1.31) mmol/mol lower for subjects with AChE/Hb=24.3 U/g (35th percentile) compared with subjects with AChE/Hb=25.8 U/g (50th percentile). Similar results were demonstrated for FPG. Fixed effect models showed less clear correlations for between-phase changes in AChE/Hb and HbA1c. Conclusions Our results do not clearly support a causal link between exposure to cholinesterase-inhibiting insecticides and elevated blood glucose levels (expressed as HbA1c and FPG), but results should be interpreted with caution due to the risk of reverse causality.
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Affiliation(s)
- Martin Rune Hassan Hansen
- Environment, Work and Health, Danish Ramazzini Centre, Department of Public Health, Aarhus University, Aarhus, Denmark .,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Erik Jørs
- Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark.,Occupational and Environmental Medicine, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Annelli Sandbæk
- General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.,Steno Diabetes Center Aarhus, Aarhus, Denmark
| | - Daniel Sekabojja
- Uganda National Association of Community and Occupational Health, Kampala, Uganda
| | | | - Ruth Mubeezi
- School of Public Health, Makerere University, Kampala, Uganda
| | - Philipp Staudacher
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland.,Institute of Biogeochemistry and Pollutant Dynamics, ETH Zürich, Zürich, Switzerland
| | - Samuel Fuhrimann
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bo Martin Bibby
- Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Vivi Schlünssen
- Environment, Work and Health, Danish Ramazzini Centre, Department of Public Health, Aarhus University, Aarhus, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
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Piccoli C, Cremonese C, Koifman R, Koifman S, Freire C. Occupational exposure to pesticides and hematological alterations: A survey of farm residents in the South of Brazil. CIENCIA & SAUDE COLETIVA 2019; 24:2325-2340. [DOI: 10.1590/1413-81232018246.13142017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/13/2017] [Indexed: 01/11/2023] Open
Abstract
Abstract This study sought to investigate the association of exposure to organochlorine (OC) and non-persistent pesticides with hematological parameters in an agricultural population in Southern Brazil. A cross-sectional study was conducted with a random sample of 275 farm workers and their families in Farroupilha-RS. A questionnaire was used to collect information on sociodemographic and lifestyle factors, duration, frequency and type of pesticide used, among others. Blood samples were collected and analyzed for serum concentration of 24 OC pesticides and hematological parameters. Associations were explored through linear regression, controlling for confounders. Lifetime use of chemical classes other than organophosphates and dithiocarbamates were associated with decreased number of lymphocytes, while subjects sampled in the high pesticide use season showed higher number of erythrocytes and hemoglobin level. Detectable serum levels of many OC pesticides were associated with lower counts of white blood cells, particularly eosinophils. Although mostly null associations were observed between pesticide use and hematological parameters, findings may suggest that OC pesticides could lead to hematological alterations among agricultural workers.
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Affiliation(s)
| | | | | | | | - Carmen Freire
- Institute of Biomedical Research of Granada, Espanha
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Bueno C, Roldan M, Anguita E, Romero-Moya D, Martín-Antonio B, Rosu-Myles M, del Cañizo C, Campos F, García R, Gómez-Casares M, Fuster JL, Jurado M, Delgado M, Menendez P. Bone marrow mesenchymal stem cells from patients with aplastic anemia maintain functional and immune properties and do not contribute to the pathogenesis of the disease. Haematologica 2014; 99:1168-75. [PMID: 24727813 DOI: 10.3324/haematol.2014.103580] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aplastic anemia is a life-threatening bone marrow failure disorder characterized by peripheral pancytopenia and marrow hypoplasia. The majority of cases of aplastic anemia remain idiopathic, although hematopoietic stem cell deficiency and impaired immune responses are hallmarks underlying the bone marrow failure in this condition. Mesenchymal stem/stromal cells constitute an essential component of the bone marrow hematopoietic microenvironment because of their immunomodulatory properties and their ability to support hematopoiesis, and they have been involved in the pathogenesis of several hematologic malignancies. We investigated whether bone marrow mesenchymal stem cells contribute, directly or indirectly, to the pathogenesis of aplastic anemia. We found that mesenchymal stem cell cultures can be established from the bone marrow of aplastic anemia patients and display the same phenotype and differentiation potential as their counterparts from normal bone marrow. Mesenchymal stem cells from aplastic anemia patients support the in vitro homeostasis and the in vivo repopulating function of CD34(+) cells, and maintain their immunosuppressive and anti-inflammatory properties. These data demonstrate that bone marrow mesenchymal stem cells from patients with aplastic anemia do not have impaired functional and immunological properties, suggesting that they do not contribute to the pathogenesis of the disease.
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Affiliation(s)
- Clara Bueno
- Josep Carreras Leukemia Research Institute, Cell Therapy Program of the University of Barcelona, Faculty of Medicine, Barcelona, Spain
| | - Mar Roldan
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain
| | - Eduardo Anguita
- Servicio de Hematología, Hospital Clínico San Carlos, Madrid, Spain
| | - Damia Romero-Moya
- Josep Carreras Leukemia Research Institute, Cell Therapy Program of the University of Barcelona, Faculty of Medicine, Barcelona, Spain
| | - Beatriz Martín-Antonio
- Josep Carreras Leukemia Research Institute, Cell Therapy Program of the University of Barcelona, Faculty of Medicine, Barcelona, Spain
| | - Michael Rosu-Myles
- Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Consuelo del Cañizo
- Department of Hematology, University Hospital of Salamanca and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Francisco Campos
- Department of Neurology, Neurovascular Area, Clinical Neurosciences Research Laboratory, Hospital Clínico-Health Research Institute of Santiago de Compostela, Spain
| | - Regina García
- Servicio de Hematología, Hospital Clínico de Málaga, Málaga, Spain
| | - Maite Gómez-Casares
- Servicio de Hematología, Hospital Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
| | - Jose Luis Fuster
- Sección de Oncohematología Pediátrica, Hospital Virgen de Arrixaca, Murcia, Spain
| | - Manuel Jurado
- Servicio de Hematología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Mario Delgado
- Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Granada, Spain
| | - Pablo Menendez
- Josep Carreras Leukemia Research Institute, Cell Therapy Program of the University of Barcelona, Faculty of Medicine, Barcelona, Spain Instituciò Catalana de Reserca i Estudis Avançats (ICREA), Barcellona, Spain
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8
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Maluf E, Hamerschlak N, Cavalcanti AB, Júnior AA, Eluf-Neto J, Falcão RP, Lorand-Metze IG, Goldenberg D, Santana CL, Rodrigues DDOW, Passos LNDM, Rosenfeld LGM, Pitta M, Loggetto S, Ribeiro AAF, Velloso ED, Kondo AT, Coelho EODM, Pintão MCT, de Souza HM, Borbolla JR, Pasquini R. Incidence and risk factors of aplastic anemia in Latin American countries: the LATIN case-control study. Haematologica 2009; 94:1220-6. [PMID: 19734415 DOI: 10.3324/haematol.2008.002642] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
UNLABELLED Background Associations between aplastic anemia and numerous drugs, pesticides and chemicals have been reported. However, at least 50% of the etiology of aplastic anemia remains unexplained. DESIGN AND METHODS This was a case-control, multicenter, multinational study, designed to identify risk factors for agranulocytosis and aplastic anemia. The cases were patients with diagnosis of aplastic anemia confirmed through biopsy or bone marrow aspiration, selected through an active search of clinical laboratories, hematology clinics and medical records. The controls did not have either aplastic anemia or chronic diseases. A total of 224 patients with aplastic anemia were included in the study, each case was paired with four controls, according to sex, age group, and hospital where the case was first seen. Information was collected on demographic data, medical history, laboratory tests, medications, and other potential risk factors prior to diagnosis. RESULTS The incidence of aplastic anemia was 1.6 cases per million per year. Higher rates of benzene exposure (>/=30 exposures per year) were associated with a greater risk of aplastic anemia (odds ratio, OR: 4.2; 95% confidence interval, CI: 1.82-9.82). Individuals exposed to chloramphenicol in the previous year had an adjusted OR for aplastic anemia of 8.7 (CI: 0.87-87.93) and those exposed to azithromycin had an adjusted OR of 11.02 (CI 1.14-108.02). Conclusions The incidence of aplastic anemia in Latin America countries is low. Although the research study centers had a high coverage of health services, the underreporting of cases of aplastic anemia in selected regions can be discussed. Frequent exposure to benzene-based products increases the risk for aplastic anemia. Few associations with specific drugs were found, and it is likely that some of these were due to chance alone.
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Affiliation(s)
- Eliane Maluf
- Centro de Pesquisa Clínica, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Avenida Albert Einstein 627/701, Piso Chinuch, São Paulo (SP), Brazil
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Issaragrisil S, Kaufman DW, Anderson T, Chansung K, Leaverton PE, Shapiro S, Young NS. The epidemiology of aplastic anemia in Thailand. Blood 2006; 107:1299-307. [PMID: 16254144 PMCID: PMC1895423 DOI: 10.1182/blood-2005-01-0161] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2005] [Accepted: 07/26/2005] [Indexed: 11/20/2022] Open
Abstract
Aplastic anemia has been linked to environmental exposures, from chemicals and medical drugs to infectious agents. The disease occurs more frequently in Asia than in the West, with incidence rates 2- to 3-fold higher. We report updated results of an epidemiologic study conducted in Thailand from 1989 to 2002, in which 541 patients and 2261 controls were enrolled. Exposures were determined by in-person interview. We observed significantly elevated relative risk estimates for benzene (3.5) and other solvents (2.0) and for sulfonamides (5.6), thiazides (3.8), and mebendazole (3.0). Chloramphenicol use was infrequent, and no significant association was observed. Agricultural pesticides were implicated in Khonkaen (northeastern Thailand). There were significant associations with organophosphates (2.1), DDT (6.7), and carbamates (7.4). We found significant risks for farmers exposed to ducks and geese (3.7) and a borderline association with animal fertilizer (2.1). There was a significant association in Khonkaen with drinking other than bottled or distilled water (2.8). Nonmedical needle exposure was associated in Bangkok and Khonkaen combined (3.8). Most striking was the large etiologic fraction in a rural region accounted for by animal exposures and drinking of water from sources such as wells, rural taps, and rainwater, consistent with an infectious etiology for many cases of aplastic anemia in Thailand.
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Affiliation(s)
- Surapol Issaragrisil
- Division of Hematology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
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Muir KR, Chilvers CED, Harriss C, Coulson L, Grainge M, Darbyshire P, Geary C, Hows J, Marsh J, Rutherford T, Taylor M, Gordon-Smith EC. The role of occupational and environmental exposures in the aetiology of acquired severe aplastic anaemia: a case control investigation. Br J Haematol 2003; 123:906-14. [PMID: 14632783 DOI: 10.1046/j.1365-2141.2003.04718.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aplastic anaemia is a rare but serious disorder with a high morbidity and mortality rate. The causes of aplastic anaemia are, for the most part, unknown. We report on the hypothesis that aplastic anaemia may be caused by occupational and/or environmental exposures to certain chemicals. The UK Aplastic Anaemia Study was an interview-based case-control study covering the whole of Great Britain. Those patients diagnosed between 1 July 1993 and 20 October 1997, aged < or =75 years and born and diagnosed in the UK were eligible for the study. Two hundred eligible cases of aplastic anaemia were compared with 387 age- and sex-matched controls. A number of occupational exposures showed increases in risk. In a multivariate model of these exposures the odds ratios (ORs) for solvents/degreasing agents, pesticides and radiation were >2 and statistically significant. Reported chemical treatment of houses within 5 years of diagnosis had a significantly raised risk for adults [OR = 2.51, 95% confidence interval (CI) 1.02-12.01], particularly for woodworm treatment (OR = 5.1, 95% CI 1.5-17.4). This study identified significant risks associated with self-reported exposure to solvents, radiation and pesticides in the workplace. Self-reported chemical treatment of houses was also associated with an increased risk of developing aplastic anaemia, in keeping with previous literature.
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Affiliation(s)
- K R Muir
- Division of Public Health Medicine and Epidemiology, Medical School, University of Nottingham, Nottingham, UK.
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Maluf EMCP, Pasquini R, Eluf JN, Kelly J, Kaufman DW. Aplastic anemia in Brazil: incidence and risk factors. Am J Hematol 2002; 71:268-74. [PMID: 12447955 DOI: 10.1002/ajh.10232] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study is the first large-scale epidemiological investigation of acquired aplastic anemia (AAA) in South America. The objective was to estimate the incidence and to identify risk factors for AAA in Brazil. A national case-control study was conducted to investigate the risk factors for the disease. One hundred twenty-five cases and 129 controls were included. Multiple logistic regression was used in the estimation of odds ratios (OR) to control confounding. The size of Brazil made it unfeasible to estimate the incidence of AAA in the whole country, and we limited the calculation to the state of Parana. The annual incidence of AAA in Parana was 2.4 cases/10(6) inhabitants. There was no positive association between chloramphenicol use and AAA (OR 0.4; 95% CI: 0.1-2.9). The OR of AAA associated with household pesticides that include organophosphates in their composition was 2.7 (1.0-8.4). The OR for the usage of unspecified thinner and/or acetone for at least 7 days was 3.0 (1.2-7.3). Cases of AAA in Brazil seem to be associated with some factors traditionally related to this disease, such as certain solvents and the incidence is similar to what has been reported from Europe.
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Affiliation(s)
- Eliane M C P Maluf
- Bone Marrow Transplantation Center, Faculty of Medicine, Federal University of Parana, Curitiba, Brazil.
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12
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Issaragrisil S, Leaverton PE, Chansung K, Thamprasit T, Porapakham Y, Vannasaeng S, Piankijagum A, Kaufman DW, Anderson TE, Shapiro S, Young NS. Regional patterns in the incidence of aplastic anemia in Thailand. The Aplastic Anemia Study Group. Am J Hematol 1999; 61:164-8. [PMID: 10398308 DOI: 10.1002/(sici)1096-8652(199907)61:3<164::aid-ajh2>3.0.co;2-r] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The annual incidence of aplastic anemia has been determined in a rigorous and standardized epidemiologic study conducted in Thailand. A total of 374 cases were identified over a period of 3-6 years in three geographically defined and distinct regions of the country; Bangkok, Khonkaen in the northeast, and Songkla in the south. The incidence was 3.9 cases per million persons in Bangkok, 3.0 per million in Songkla, and 5.0 per million in Khonkaen. These rates are as high or higher than in any region of Europe or Israel as reported in the International Agranulocytosis and Aplastic Anemia Study, in which the methods and case definition were the same. Rates were stable over the course of the study. There were marked differences in incidence between northern and southern rural regions of Thailand, and among Bangkok suburbs. These differences, together with an unusual peak in the incidence among young people in Bangkok, suggest the possibility of occupational and environmental factors in the etiology of aplastic anemia.
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Affiliation(s)
- S Issaragrisil
- Department of Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
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