AN OUTBREAK OF HYPERVITAMINOSIS-D ASSOCIATED WITH THE OVERFORTIFICATION OF MILK FROM A HOME-DELIVERY DAIRY
AN OUTBREAK OF HYPERVITAMINOSIS-D ASSOCIATED WITH THE OVERFORTIFICATION OF MILK FROM A HOME-DELIVERY DAIRY
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DOI：
10.2105/ajph.85.5.656
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发表时间：
1995-05-01
影响因子：
12.7
通讯作者：
FALK, H
中科院分区：
文献类型：
--
作者：
BLANK, S;SCANLON, KS;FALK, H
目标.该研究的目的是确定由家庭交付的牛奶无意中过度强化牛奶引起的维生素D过多症的病例，并确定这种疾病的危险因素。医院出院，实验室，和国家卫生部门的数据被用来定义，识别和描述的情况下，维生素D暴露的社区诊断1985年1月1日至1991年6月30日。为了确定疾病的危险因素，在一项病例对照研究中使用了基于社区的性别和年龄匹配的对照。在确定的56例患者中，至少有41人住院; 2人死亡。该研究包括33例病例患者和93例对照受试者。33例患者中有19例是涉事奶制品的顾客。患病风险随着牛奶消费量的增加而增加，并且还与维生素D补充剂的使用，晒伤易感性和癌症史有关。考虑到这些因素并没有改变饮用牛奶和发展维生素D过多症之间的关联。过度强化牛奶中的维生素D会导致维生素D过多症，表现为严重的疾病和死亡。这一事件突出表明，需要监测强化过程，并执行牛奶中维生素D添加量的上限。
Objectives. The purpose of the study was to identify cases of hypervitaminosis D caused by the inadvertent overfortification of milk from a home-delivery dairy and to identify risk factors for this illness.Methods. Hospital discharge, laboratory, and state health department data were used to define, identify, and describe cases of hypervitaminosis D diagnosed in the exposed communities between January 1, 1985, and June 30, 1991. To identify disease risk factors, community-based sex- and age-matched controls were used in a case-control study.Results. Of the 56 case patients identified, at least 41 were hospitalized; 2 died. The study included 33 case patients and 93 control subjects. Nineteen of the 33 case patients had been customers of the implicated dairy. Risk of illness rose with increasing consumption of the dairy's milk and was also associated with vitamin D supplement use, sunburn susceptibility, and cancer history. Accounting for these factors did not alter the association between drinking the dairy's milk and developing hypervitaminosis D.Conclusions. Overfortification of milk with vitamin D can lead to hypervitaminosis D, manifested by severe illness and death. The episode highlights the need for monitoring the fortification process and enforcing the upper limit for vitamin D addition to milk.