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To investigate whether paresthesia of the lower extremities following exposure to the World Trade Center (WTC) disaster was associated with signs of neuropathy, metabolic abnormalities, or neurotoxin exposures. Case-control study comparing WTC-exposed paresthesia cases with "clinic controls" (WTC-exposed subjects without paresthesias), and "community controls" (WTC-unexposed persons). Neurological histories and examination findings were significantly worse in cases than controls. Intraepidermal nerve fiber densities were below normal in 47% of cases and sural to radial sensory nerve amplitude ratios were less than 0.4 in 29.4%. Neurologic abnormalities were uncommon among WTC-unexposed community controls. Metabolic conditions and neurotoxin exposures did not differ among groups. Paresthesias among WTC-exposed individuals were associated with signs of neuropathy, small and large fiber disease. The data support WTC-related exposures as risk factors for neuropathy, and do not support non-WTC etiologies.


Michael Marmor, Sujata Thawani, Maria Luisa Cotrina, Yongzhao Shao, Ericka S Wong, Mark M Stecker, Bin Wang, Alexander Allen, Marc Wilkenfeld, Etta J Vinik, Aaron I Vinik, Joan Reibman. Case-Control Study of Paresthesia Among World Trade Center-Exposed Community Members. Journal of occupational and environmental medicine. 2020 Apr;62(4):307-316

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PMID: 32049876

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