| An
elevated prevalence of systemic lupus erythematosus (SLE) was reported
in Nogales, Arizona and Rio Rico, a nearby community. In March 1997, the
Arizona Department of Health Services (ADHS) requested
assistance from the Centers for Disease Control and Prevention (CDC)
to conduct a case-control study to determine whether exposure to
chemicals in the environment was associated with SLE among residents of
Nogales. We conducted a two-phase study to address this question. The
objectives of Phase I were to identify potential SLE cases in Nogales,
determine the prevalence of SLE in Nogales and determine if there was a
seasonal pattern to the appearance of SLE symptoms. The objectives of
Phase II were to identify potential risk factors associated with
development of SLE in Nogales and to evaluate the possible association
between SLE and environmental exposure to pesticides and inorganic
compounds.
The study
participants included 20 confirmed cases and 36 controls. In Nogales,
Arizona, the prevalence of SLE found in phase I of this study was 20
cases per 19,849 people. or 103 cases per 100,000 population,
approximately two to seven cases higher than the national prevalence.
Income and employment did not differ significantly
between cases and controls, except for educational level. Information on
symptom severity obtained through three month diaries did not show any
seasonal pattern in disease severity.
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As a
response to the prevalence of lupus in the community, lay health workers
are being trained to support people with lupus... |
Toxicologic analysis
showed that DDE and organophosphate metabolites were detected at
elevated levels among cases and controls. Levels detected in both were
higher than the reference mean or median for the U.S. population.
However, the mean, median and frequency distributions for both cases and
controls were remarkably similar, indicating no association between SLE
and these chemical exposures. In addition, the univariate analysis
demonstrated no statistical association between elevated levels of
pesticides and disease status.
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