PDF(Pubmed)
Abstract：
BACKGROUND: Environmental vinyl chloride (VC) exposure may result in serious acute and chronic dermatological conditions. Because existing literature largely focuses on exposures in occupational settings, a gap persists in our understanding of the medical consequences of large-scale chemical spills.
OBJECTIVE: This study aims to examine the potential dermatological manifestations of VC exposure in the context of industrial spills and other environmental disasters and to highlight the public health and justice implications of such releases.
METHODS: In this narrative review, relevant evidence-based, peer-reviewed scientific sources, gray literature, and media reports were identified via searches of search PubMed and Google using predetermined keyword search terms related to VC, VC spills and releases, train derailment, cutaneous disease, public health, and vulnerable and marginalized populations.
RESULTS: Contact dermatitis and frostbite may arise acutely, highlighting the importance of swift decontamination. Long-term manifestations from chronic VC exposure due to persistence in environmental reservoirs include Raynaud disease, sclerodermatous skin changes, acro-osteolysis, and cutaneous malignancies. The clinical severity of cutaneous manifestations is influenced by individual susceptibility as well as duration, intensity, and route of exposure. Additionally, chemical releases of VC more frequently impact Communities of Color and those of lower socioeconomic status, resulting in greater rates of exposure-related disease.
CONCLUSIONS: With environmental release events of hazardous chemicals becoming increasingly common and because the skin has increased contact with environmental toxins relative to other organs, an urgent need exists for a greater understanding of the overall short- and long-term health impacts of large-scale, toxic exposures, underscoring the need for ongoing clinical vigilance. Dermatologists and public health officials should also aim to better understand the ways in which the disproportionate impacts of hazardous chemical exposures on lower-income and minority populations may exacerbate existing health disparities. Herein, we describe the health implications of toxic releases with particular consideration paid to marginalized and vulnerable populations. In addition to legal and regulatory frameworks, we advocate for improved public health measures, to not only mitigate the risk of environmental catastrophes in the future, but also ensure timely and effective responses to them.
OBJECTIVE: This study aims to examine the potential dermatological manifestations of VC exposure in the context of industrial spills and other environmental disasters and to highlight the public health and justice implications of such releases.
METHODS: In this narrative review, relevant evidence-based, peer-reviewed scientific sources, gray literature, and media reports were identified via searches of search PubMed and Google using predetermined keyword search terms related to VC, VC spills and releases, train derailment, cutaneous disease, public health, and vulnerable and marginalized populations.
RESULTS: Contact dermatitis and frostbite may arise acutely, highlighting the importance of swift decontamination. Long-term manifestations from chronic VC exposure due to persistence in environmental reservoirs include Raynaud disease, sclerodermatous skin changes, acro-osteolysis, and cutaneous malignancies. The clinical severity of cutaneous manifestations is influenced by individual susceptibility as well as duration, intensity, and route of exposure. Additionally, chemical releases of VC more frequently impact Communities of Color and those of lower socioeconomic status, resulting in greater rates of exposure-related disease.
CONCLUSIONS: With environmental release events of hazardous chemicals becoming increasingly common and because the skin has increased contact with environmental toxins relative to other organs, an urgent need exists for a greater understanding of the overall short- and long-term health impacts of large-scale, toxic exposures, underscoring the need for ongoing clinical vigilance. Dermatologists and public health officials should also aim to better understand the ways in which the disproportionate impacts of hazardous chemical exposures on lower-income and minority populations may exacerbate existing health disparities. Herein, we describe the health implications of toxic releases with particular consideration paid to marginalized and vulnerable populations. In addition to legal and regulatory frameworks, we advocate for improved public health measures, to not only mitigate the risk of environmental catastrophes in the future, but also ensure timely and effective responses to them.
摘要：
背景：环境氯乙烯（VC）暴露可能会导致严重的急性和慢性皮肤病。因为现有文献主要集中在职业环境中的暴露，我们对大规模化学品泄漏的医疗后果的理解仍然存在差距。
目的：本研究旨在研究在工业泄漏和其他环境灾难的背景下，VC暴露的潜在皮肤病学表现，并强调此类释放对公共卫生和司法的影响。
方法：在这篇叙述性综述中，相关证据为基础，同行评审的科学来源，灰色文学,和媒体报道是通过使用与VC相关的预定关键字搜索词搜索PubMed和Google的搜索来识别的，VC溢出和释放，火车脱轨,皮肤病,公共卫生,以及弱势和边缘化人群。
结果：接触性皮炎和冻伤可能会出现，强调快速净化的重要性。由于环境水库的持续存在而导致的慢性VC暴露的长期表现包括雷诺病，硬化皮肤变化，肢端骨溶解,和皮肤恶性肿瘤.皮肤表现的临床严重程度受个体易感性和持续时间的影响。强度,和曝光的途径。此外,VC的化学释放更频繁地影响有色人种和社会经济地位较低的群体，导致暴露相关疾病的发生率更高。
结论：随着危险化学品的环境释放事件变得越来越普遍，并且由于皮肤相对于其他器官与环境毒素的接触增加，迫切需要更好地了解大规模的短期和长期健康影响，有毒物质暴露,强调需要持续的临床警惕。皮肤科医生和公共卫生官员还应致力于更好地了解危险化学品暴露对低收入和少数群体的不成比例影响可能加剧现有健康差距的方式。在这里，我们描述了有毒物质释放对健康的影响，并特别考虑了边缘化和弱势群体。除了法律和监管框架之外，我们主张改善公共卫生措施，不仅减轻了未来环境灾难的风险，但也要确保对它们做出及时有效的反应。
目的：本研究旨在研究在工业泄漏和其他环境灾难的背景下，VC暴露的潜在皮肤病学表现，并强调此类释放对公共卫生和司法的影响。
方法：在这篇叙述性综述中，相关证据为基础，同行评审的科学来源，灰色文学,和媒体报道是通过使用与VC相关的预定关键字搜索词搜索PubMed和Google的搜索来识别的，VC溢出和释放，火车脱轨,皮肤病,公共卫生,以及弱势和边缘化人群。
结果：接触性皮炎和冻伤可能会出现，强调快速净化的重要性。由于环境水库的持续存在而导致的慢性VC暴露的长期表现包括雷诺病，硬化皮肤变化，肢端骨溶解,和皮肤恶性肿瘤.皮肤表现的临床严重程度受个体易感性和持续时间的影响。强度,和曝光的途径。此外,VC的化学释放更频繁地影响有色人种和社会经济地位较低的群体，导致暴露相关疾病的发生率更高。
结论：随着危险化学品的环境释放事件变得越来越普遍，并且由于皮肤相对于其他器官与环境毒素的接触增加，迫切需要更好地了解大规模的短期和长期健康影响，有毒物质暴露,强调需要持续的临床警惕。皮肤科医生和公共卫生官员还应致力于更好地了解危险化学品暴露对低收入和少数群体的不成比例影响可能加剧现有健康差距的方式。在这里，我们描述了有毒物质释放对健康的影响，并特别考虑了边缘化和弱势群体。除了法律和监管框架之外，我们主张改善公共卫生措施，不仅减轻了未来环境灾难的风险，但也要确保对它们做出及时有效的反应。
