Abstract
Although the clinical manifestations of acute sarin poisoning have been reported in detail, no comprehensive study of the chronic physical and psychiatric effects of acute sarin poisoning has been carried out. To clarify the chronic effects of sarin on the nervous system, a cross-sectional epidemiologic study was conducted 3 years after the Tokyo subway sarin attack. Subjects consisted of the rescue team staff members and police officers who had worked at the disaster site. Subjects consisted of 56 male exposed subjects and 52 referent subjects matched for age and occupation. A neurobehavioral test, stabilometry, and measurement of vibration perception thresholds were performed, as well as psychometric tests to assess traumatic stress symptoms. The exposed group performed less well in the backward digit span test than the referent group in a dose-effect manner. This result was the same after controlling for possible confounding factors and was independent of traumatic stress symptoms. In other tests of memory function, except for the Benton visual retention test (mean correct answers), effects related to exposure were also suggested, although they were not statistically significant. In contrast, the dose-effect relationships observed in the neurobehavioral tests (psychomotor function) were unclear. None of the stabilometry and vibration perception threshold parameters had any relation to exposure. Our findings suggest the chronic decline of memory function 2 years and 10 months to 3 years and 9 months after exposure to sarin in the Tokyo subway attack, and further study is needed.
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- Burchfiel J. L., Duffy F. H. Organophosphate neurotoxicity: chronic effects of sarin on the electroencephalogram of monkey and man. Neurobehav Toxicol Teratol. 1982 Nov-Dec;4(6):767–778. [PubMed] [Google Scholar]
- Carlier I. V., Lamberts R. D., Fouwels A. J., Gersons B. P. PTSD in relation to dissociation in traumatized police officers. Am J Psychiatry. 1996 Oct;153(10):1325–1328. doi: 10.1176/ajp.153.10.1325. [DOI] [PubMed] [Google Scholar]
- Chebabo S. R., Santos M. D., Albuquerque E. X. The organophosphate sarin, at low concentrations, inhibits the evoked release of GABA in rat hippocampal slices. Neurotoxicology. 1999 Dec;20(6):871–882. [PubMed] [Google Scholar]
- Duffy F. H., Burchfiel J. L., Bartels P. H., Gaon M., Sim V. M. Long-term effects of an organophosphate upon the human electroencephalogram. Toxicol Appl Pharmacol. 1979 Jan;47(1):161–176. doi: 10.1016/0041-008x(79)90083-8. [DOI] [PubMed] [Google Scholar]
- Horowitz M., Wilner N., Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979 May;41(3):209–218. doi: 10.1097/00006842-197905000-00004. [DOI] [PubMed] [Google Scholar]
- Hui D. M., Minami M. Monitoring of fluorine in urine samples of patients involved in the tokyo sarin disaster, in connection with the detection of other decomposition products of sarin and the by-products generated during sarin synthesis. Clin Chim Acta. 2000 Dec;302(1-2):171–188. doi: 10.1016/s0009-8981(00)00364-8. [DOI] [PubMed] [Google Scholar]
- Kato T., Hamanaka T. Ocular signs and symptoms caused by exposure to sarin gas. Am J Ophthalmol. 1996 Feb;121(2):209–210. doi: 10.1016/s0002-9394(14)70587-2. [DOI] [PubMed] [Google Scholar]
- Kitamura T., Sugawara M., Aoki M., Shima S. Validity of the Japanese version of the GHQ among antenatal clinic attendants. Psychol Med. 1989 May;19(2):507–511. doi: 10.1017/s0033291700012538. [DOI] [PubMed] [Google Scholar]
- McFarlane A. C. The longitudinal course of posttraumatic morbidity. The range of outcomes and their predictors. J Nerv Ment Dis. 1988 Jan;176(1):30–39. doi: 10.1097/00005053-198801000-00004. [DOI] [PubMed] [Google Scholar]
- Minami M., Hui D. M., Wang Z., Katsumata M., Inagaki H., Li Q., Inuzuka S., Mashiko K., Yamamoto Y., Ootsuka T. Biological monitoring of metabolites of sarin and its by-products in human urine samples. J Toxicol Sci. 1998 Jul;23 (Suppl 2):250–254. doi: 10.2131/jts.23.supplementii_250. [DOI] [PubMed] [Google Scholar]
- Morishita S., Aoki S., Watanabe S. Clonazepam as a therapeutic adjunct to improve the management of psychiatric disorders. Psychiatry Clin Neurosci. 1998 Feb;52(1):75–78. doi: 10.1111/j.1440-1819.1998.tb00976.x. [DOI] [PubMed] [Google Scholar]
- Morita H., Yanagisawa N., Nakajima T., Shimizu M., Hirabayashi H., Okudera H., Nohara M., Midorikawa Y., Mimura S. Sarin poisoning in Matsumoto, Japan. Lancet. 1995 Jul 29;346(8970):290–293. doi: 10.1016/s0140-6736(95)92170-2. [DOI] [PubMed] [Google Scholar]
- Murata K., Araki S., Yokoyama K., Okumura T., Ishimatsu S., Takasu N., White R. F. Asymptomatic sequelae to acute sarin poisoning in the central and autonomic nervous system 6 months after the Tokyo subway attack. J Neurol. 1997 Oct;244(10):601–606. doi: 10.1007/s004150050153. [DOI] [PubMed] [Google Scholar]
- Nakajima T., Ohta S., Morita H., Midorikawa Y., Mimura S., Yanagisawa N. Epidemiological study of sarin poisoning in Matsumoto City, Japan. J Epidemiol. 1998 Mar;8(1):33–41. doi: 10.2188/jea.8.33. [DOI] [PubMed] [Google Scholar]
- Nakajima T., Sato S., Morita H., Yanagisawa N. Sarin poisoning of a rescue team in the Matsumoto sarin incident in Japan. Occup Environ Med. 1997 Oct;54(10):697–701. doi: 10.1136/oem.54.10.697. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Okumura T., Takasu N., Ishimatsu S., Miyanoki S., Mitsuhashi A., Kumada K., Tanaka K., Hinohara S. Report on 640 victims of the Tokyo subway sarin attack. Ann Emerg Med. 1996 Aug;28(2):129–135. doi: 10.1016/s0196-0644(96)70052-5. [DOI] [PubMed] [Google Scholar]
- Rengstorff R. H. Accidental exposure to sarin: vision effects. Arch Toxicol. 1985 Jan;56(3):201–203. doi: 10.1007/BF00333427. [DOI] [PubMed] [Google Scholar]
- Rocha E. S., Chebabo S. R., Santos M. D., Aracava Y., Albuquerque E. X. An analysis of low level doses of cholinesterase inhibitors in cultured neurons and hippocampal slices of rats. Drug Chem Toxicol. 1998;21 (Suppl 1):191–200. doi: 10.3109/01480549809007411. [DOI] [PubMed] [Google Scholar]
- Rosenstock L., Keifer M., Daniell W. E., McConnell R., Claypoole K. Chronic central nervous system effects of acute organophosphate pesticide intoxication. The Pesticide Health Effects Study Group. Lancet. 1991 Jul 27;338(8761):223–227. doi: 10.1016/0140-6736(91)90356-t. [DOI] [PubMed] [Google Scholar]
- Suzuki J., Kohno T., Tsukagosi M., Furuhata T., Yamazaki K. Eighteen cases exposed to sarin in Matsumoto, Japan. Intern Med. 1997 Jul;36(7):466–470. doi: 10.2169/internalmedicine.36.466. [DOI] [PubMed] [Google Scholar]
- Yokoyama K., Araki S., Murata K., Nishikitani M., Okumura T., Ishimatsu S., Takasu N., White R. F. Chronic neurobehavioral effects of Tokyo subway sarin poisoning in relation to posttraumatic stress disorder. Arch Environ Health. 1998 Jul-Aug;53(4):249–256. doi: 10.1080/00039899809605705. [DOI] [PubMed] [Google Scholar]
