Health Status Measurement in Toxic Oil Syndrome

Cámara, Agustı́n Gómez de la; Paz, Manuel Posada de la; Borda, Ignacio Abaitua; Oyagüe, Maria Teresa Barainca; Santos, Víctor Abraira; Ruiz-Navarro, Mercedes Díez; Terracini, Benedetto

doi:10.1016/s0895-4356(98)00062-6

Cited by 23 publications

(9 citation statements)

References 18 publications

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“…Compared with previous studies on samples of the Spanish general population, impairment scores of TOS patients obtained with the latter questionnaire were three times higher (21).…”

Section: Prevalence Of Chronic Conditions In the 1990scontrasting

confidence: 80%

The Spanish Toxic Oil Syndrome 20 Years after Its Onset: A Multidisciplinary Review of Scientific Knowledge

Gelpí¹,

Паз²,

Terracini³

et al. 2002

Environ Health Perspect

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“…Compared with previous studies on samples of the Spanish general population, impairment scores of TOS patients obtained with the latter questionnaire were three times higher (21).…”

Section: Prevalence Of Chronic Conditions In the 1990scontrasting

confidence: 80%

The Spanish Toxic Oil Syndrome 20 Years after Its Onset: A Multidisciplinary Review of Scientific Knowledge

Gelpí¹,

Паз²,

Terracini³

et al. 2002

Environ Health Perspect

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“…The number of victims totaled over 20,000 with a female-to-male ratio of 1.5:1 [80]. Follow-up studies have supported the 2-to-1 predominance in females [80, 81] and have noted that the prevalence of severe scleroderma-like changes [81] and TOS-related deaths [80] are 2-to-3 fold higher in women than men.…”

Section: Gender In Environmentally-induced Human Autoimmunitymentioning

confidence: 99%

Gender differences in autoimmunity associated with exposure to environmental factors

Pollard¹

2012

Journal of Autoimmunity

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Autoimmunity is thought to result from a combination of genetics, environmental triggers, and stochastic events. Gender is also a significant risk factor with many diseases exhibiting a female bias. Although the role of environmental triggers, especially medications, in eliciting autoimmunity is well established less is known about the interplay between gender, the environment and autoimmunity. This review examines the contribution of gender in autoimmunity induced by selected chemical, physical and biological agents in humans and animal models. Epidemiological studies reveal that environmental factors can be associated with a gender bias in human autoimmunity. However many studies show that the increased risk of autoimmunity is often influenced by occupational exposure or other gender biased activities. Animal studies, although often prejudiced by the exclusive use of female animals, reveal that gender bias can be strain specific suggesting an interaction between sex chromosome complement and background genes. This observation has important implications because it argues that within a gender biased disease there may be individuals in which gender does not contribute to autoimmunity. Exposure to environmental factors, which encompasses everything around us, adds an additional layer of complexity. Understanding how the environment influences the relationship between sex chromosome complement and innate and adaptive immune responses will be essential in determining the role of gender in environmentally-induced autoimmunity.

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“…Results of a pilot of this study available for a stratified random sample of patients with toxic oil syndrome (53) show that the self-perceived health status of toxic oil syndrome patients, as measured by the Nottingham Health Profile Questionnaire, was substantially poorer than that of a comparison group taken from the general Spanish population. Patients with toxic oil syndrome scored at approximately the same level as those comparison respondents who rated their health as poor or very poor.…”

Section: Clinical Follow-up Studymentioning

confidence: 90%

Toxic Oil Syndrome: The Perspective after 20 Years

Паз

Philen

Borda

2001

Epidemiologic Reviews

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Toxic oil syndrome burst upon the scene in Spain in May of 1981, draining the resources of a newly evolving political and social medicine system. The vehicle of the causative toxic agent was identified as an illicit oil that had been diverted from industrial use and refined in order to remove the aniline denaturant, and that was sold in unlabeled 5-liter containers by itinerant salesmen. Over 20,000 people were ultimately affected, and over 1,200 deaths from all causes have been recorded in the affected cohort. The epidemiologic investigation of toxic oil syndrome involved all facets of investigative and analytical work; from visits to factories and interviewing workers, to sophisticated chemical and statistical analytical techniques. This investigation serves as a further illustration that data and information of all types, and from a wide range of fields, need to be systematically collected and evaluated in order to best resolve an epidemiologic mystery. Astute clinical observation of the patients, however, led to the hypothesis that toxic oil syndrome was a result of a toxic exposure. In this and other epidemics of unknown etiology, clinical observation and the intense scrutiny of patients' histories, signs, and symptoms by treating clinicians have often led to hypotheses that could be tested epidemiologically. When there are medical unknowns, the role of the astute clinician continues to be crucial. The toxic oil syndrome epidemic is an example of how even a developed country can be affected by a massive epidemic of environmental origin if failures occur in the systems that control and regulate the food supply or other consumer products. However, such failures could occur anywhere that large commercial networks operate on the regulatory edge, and if these business lack an in depth knowledge of the consequences of alterations in manufacturing conditions. Such was the case with eosinophilia-myalgia syndrome as well, when apparently minor alterations in manufacturing conditions of L-tryptophan led to an increase in impurities in the product that were later associated with the illness. These risks are even greater in countries with few or inconsistent control systems, making the food and drug supply potential portals of entry for serious health hazards, as is further exemplified by the tragic episode of pediatric renal failure in Haiti associated with a legitimate consumer product, paracetamol elixir, that had been manufactured using a fraudulently supplied toxic ingredient, diethylene glycol (81). The potential toxicants in the adulterated rapeseed oil were present in extremely small amounts. If fatty acid anilides or related compounds are indeed the etiologic agents in toxic oil syndrome, then these compounds must be extremely toxic at the parts per million concentrations at which they were found. Further, the roles of causative agents in the development of disorders such as scleroderma, eosinophilic fasciitis, eosinophilic perimyositis, and other similar diseases are unknown, but scientists can speculate that ...

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Health Status Measurement in Toxic Oil Syndrome

Cited by 23 publications

References 18 publications

The Spanish Toxic Oil Syndrome 20 Years after Its Onset: A Multidisciplinary Review of Scientific Knowledge

The Spanish Toxic Oil Syndrome 20 Years after Its Onset: A Multidisciplinary Review of Scientific Knowledge

Gender differences in autoimmunity associated with exposure to environmental factors

Toxic Oil Syndrome: The Perspective after 20 Years

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