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Blood, 15 February 2006, Vol. 107, No. 4, pp. 1299-1307. Prepublished online as a Blood First Edition Paper on October 27, 2005; DOI 10.1182/blood-2005-01-0161. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-01-0161v1 107/4/1299    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Issaragrisil, S. Articles by Young, N. S. Search for Related Content PubMed PubMed Citation Articles by Issaragrisil, S. Articles by Young, N. S. Related Collections Immunobiology Red Cells Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS The epidemiology of aplastic anemia in Thailand Surapol Issaragrisil, David W. Kaufman, Theresa Anderson, Kanchana Chansung, Paul E. Leaverton, Samuel Shapiro, and Neal S. Young From the Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; the Slone Epidemiology Center, Boston University, MA; the Department of Medicine, Faculty of Medicine, Khonkaen University, Khonkaen, Thailand; the University of South Florida, Tampa, FL; and the Hematology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD. 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. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Aplastic anemia: what's in the environment? Judith C. W. Marsh Blood 2006 107: 1250. [Full Text] [PDF] This article has been cited by other articles: N. S. Young and D. W. Kaufman The epidemiology of acquired aplastic anemia Haematologica, April 1, 2008; 93(4): 489 - 492. [Full Text] [PDF] Z.-T. Xin, A. D. Beauchamp, R. T. Calado, J. W. Bradford, J. A. Regal, A. Shenoy, Y. Liang, P. M. Lansdorp, N. S. Young, and H. Ly Functional characterization of natural telomerase mutations found in patients with hematologic disorders Blood, January 15, 2007; 109(2): 524 - 532. [Abstract] [Full Text] [PDF] N. S. Young, R. T. Calado, and P. Scheinberg Current concepts in the pathophysiology and treatment of aplastic anemia Blood, October 15, 2006; 108(8): 2509 - 2519. [Abstract] [Full Text] [PDF] N. S. Young Pathophysiologic Mechanisms in Acquired Aplastic Anemia Hematology, January 1, 2006; 2006(1): 72 - 77. [Abstract] [Full Text] [PDF]

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