The long-term effects of occupational exposure to vinyl chloride monomer on microcirculation: a cross-sectional study 15 years after retirement

BMJ Open - Tập 3 Số 6 - Trang e002785 - 2013
Vincent Lopez1, A. Chamoux1, Marion Tempier2, H. Thiel3, Sylvie Ughetto4, Marion Trousselard5, Géraldine Naughton6, Frédéric Dutheil1,7,6
1Department of Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France
2Department of Radiopharmacy, University Hospital CHU G. Montpied, Clermont-Ferrand, France
3Department of Vascular Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France
4Department of Medical Information—Clinical research and innovation direction, University Hospital CHU G. Montpied, Clermont-Ferrand, France
5Neurophysiology of emotions, ENOP Department, CRSSA/IRBA, La Tronche, France
6School of Exercise Science, Australian Catholic University, Fitzroy, Australia
7Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P), EA3533, Blaise Pascal University, Clermont-Ferrand, France

Tóm tắt

ObjectivesTo assess residual long-term microcirculation abnormalities by capillaroscopy, 15 years after retiring from occupational exposure to vinyl chloride monomer (VCM).DesignCross-sectional study.SettingAllier, one of the major areas of polyvinyl chloride production in France.ParticipantsWe screened 761 (97% men) retired workers exposed to chemical toxics. Exposure to chemicals other than VCM excluded potential participants.Primary and secondary outcome measuresThese 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.Results179/761 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.ConclusionsAlthough 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.

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BMJ Open

Tập 3 Số 6

e002785

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