Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Aug;33(4):1085-8.
doi: 10.1007/s00264-009-0738-9. Epub 2009 Mar 17.

Effects of physical environment on the evolution of Kashin-Beck disease in Tibet

M Hinsenkamp  1 , F Mathieu, W Claus, J-F Collard, V de Maertelaer
Affiliations

Effects of physical environment on the evolution of Kashin-Beck disease in Tibet

M Hinsenkamp et al. Int Orthop. 2009 Aug.

Abstract
in English, French

In previous studies we observed a proximo-distal gradient of lesion frequencies along the limb, with the distal joints being the most often affected. This suggests an associated effect of environmental factors on the most exposed joints. On a population of 820 children (mean age 13 years) of endemic areas distributed in groups of healthy and severity stages I to III of KBD (Kashin-Beck disease), the effects of different working activities were studied. Heavy work like that of a ploughman were compared to light physical work, e.g. school children, and exposure to cold and history of frostbite were also considered. The most severe stages, II and III, were present in 72% of the ploughman vs. 29% of the schoolchildren, 70% of the shepherds vs. 30% (p < 0.001) of the schoolchildren, and in 65% of the shepherds working in winter vs. 40% of those working in the other seasons (p < 0.001). In the group with history of frostbite, 58% present the severest stages vs. 40% without (p < 0.001). The results confirm a highly significant relation between microtrauma and cold and the severity of the KBD alterations.

Dans nos précédentes études, nous avions observé un gradient de fréquence proximo-distale des lésions le long des membres, les articulations distales étant les plus souvent atteintes. Ceci suggère un effet associé des facteurs environnementaux sur les articulations les plus exposées. Sur une population de 820 enfants (âge moyen 13ans) provenant de régions endémiques et distribués en groupes sains et de stades de gravité de la maladie de KASHIN-BECK s´échelonnant de I à III, nous avons étudié les effets de différents types d´activités. Les travaux lourds, comme celui de laboureur, ont été comparés à une activité plus légère telle que celle d´écolier. Les stades les plus sévères (II et III) sont présents chez 72% des laboureurs contre 29% chez les écoliers, chez 70% des bergers contre 30% des écoliers (p<0.001) et chez 65% des bergers travaillant en hiver contre 40% chez ceux travaillant pendant les autres saisons (p<0.001). Dans le groupe présentant des antécédents de gelure, 58% présentent les stades les plus sévères contre 40% dans le groupe sans antécédents (p<0.001). Ces résultats confirment une relation très hautement significative entre les microtraumas et l´exposition au froid et la sévérité des lésions de la maladie de Kashin-Beck..

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Frequency of the radiological alterations by anatomic location on a population of 105 Kashin-Beck disease (KBD) cases [3]
Fig. 2
Fig. 2
Distribution of ages in the population studied (n = 820)
Fig. 3
Fig. 3
Percentage of stages 0 and I (grey) compared to stages II and III (black) in the different populations of workers (n = 820)
Fig. 4
Fig. 4
Percentage of stages 0 and I (grey) compared to stages II and III (black) in the population of ploughmen and in the total population of the other workers
Fig. 5
Fig. 5
Comparison of the different percentages of the stages 0–I and II–III in the groups of shepherds active in winter, shepherds working in other seasons, and the other workers (n = 820)
Fig. 6
Fig. 6
Distribution of the shepherds (grey) as percentage of all the shepherds among the different stages of severity compared to the distribution of the schoolchildren (n = 658)
Fig. 7
Fig. 7
Percentage of stages 0–I (grey) and stages II–III (black) in population doing the laundry in the river during the winter, in the other seasons, and the other workers (n = 820)
Fig. 8
Fig. 8
Percentage of stages 0–I (grey) and stages II–III (black) in the population with and without a history of frostbite (n = 820)
See this image and copyright information in PMC

References

    1. Allander E (1994) Kashin-Beck disease. An analysis of research and public health activities based on a bibliography. Scand J Rheumatol (23):1849–1992 - PubMed
    1. Chasseur C, Suetens C, Nolard N, Begaux F, Haubruge E. Fungal contamination in barley and Kashin-Beck disease in Tibet. Lancet. 1997;350:1074. doi: 10.1016/S0140-6736(05)70453-0. - DOI - PubMed
    1. Chasseur C, Suetens C, Michel V, Mathieu F, Begaux F, Nolard N, Haubruge E. A 4-year study of the mycological aspects of Kashin-Beck disease in Tibet. Int Orthop. 2001;25(3):154–159. doi: 10.1007/s002640000218. - DOI - PMC - PubMed
    1. Chasseur C, Suetens C, Begaux F, Haubruge E, Wangla R, Rinchen L, Wangdu L, Claus W, Mathieu F (2008) The mineral deficiency hypothesis. In: Malaisse F, Mathieu F (eds) “Big Bone Disease”. Presse Agro de Gembloux, pp 101–103
    1. Chasseur C, Lognay G, Suetens C, Rapten S, Gillet P, Kanyandekwe P, He L, Drolkar P, Wangla R, Begaux F, Haubruge E, Rinchen L, Wangdu L, Claus W, Mathieu F (2008) The fungal hypotheses. In: Malaisse F, Mathieu F (eds) “Big Bone Disease”. Presse Agro de Gembloux, pp 85–99