American Journal of Epidemiology Vol. 88, No. 1: 7-24
Copyright © 1968 by The Johns Hopkins University School of Hygiene and Public Health
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A CONTROLLED RETROSPECTIVE STUDY OF BLACKFOOT DISEASE, AN ENDEMIC PERIPHERAL GANGRENE DISEASE IN TAIWAN
1National Defense Medical Center Taipei, Taiwan, Republic of China
2Department of Biochemistry U. S. Naval Medical Research Unit No. 2 Taipei, Taiwan, Republic of China. Bureau of Medicine and Surgery, Navy Department Washington, D. C., Project MR005.09-0039
Ch'i, I-Cheng (Nat. Defense Med. Ctr., Taipei, Taiwan) and R. Q. Blackwell. A controlled retrospective study of Blackfoot Disease, an endemic peripheral gangrene disease in Taiwan. Amer. J. Epid., 1968, 88; 7-24.—Blackfoot (BF) disease occurs in one small endemic area of Taiwan where it has been recognized for approximately 50 years. The condition affects young and old of both sexes and clinically resembles thromboangiitis obliterans; it generally causes loss of toes and, less frequently, loss of fingers. Previous studies had reported an association between the disease and the consumption of deep well water. The present controlled retrospective study of 353 patients with BF disease and 353 matched controls disclosed no striking differences between the groups except the doser association in the BF group of a history of long consumption of deep well water. That association was evaluated by several approaches and appears to be firmly established.
Our previous laboratory studies had established that the deep well water contained appreciable levels of arsenic Furthermore, those residents of the endemic area who were consuming deep well water, including BF subjects as well as their relatives and neighbors, were found to excrete elevated levels of arsenic in hair and urine. It was concluded from our present epidemiologic study and our past laboratory work that arsenic, primarily from deep well water, is a likely etidogic factor in Blackfoot disease.
1 Present address: Dept. of Population & Family Health, The Johns Hopkins Univ. Schl. Hygiene, 615 N. Wolfe St., Baltimore, Md. 21205
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