RESUMO
PURPOSE: In 1981, a progressive multi-systemic disease called Toxic Oil Syndrome (TOS) appeared in Spain as an epidemic that affected 20,000 people. The International Classification of Impairments, Disabilities and Handicaps (ICIDH) was chosen to characterize the health status of patients more severely affected by TOS. METHODS: A random sample of 292 with permanent disability was selected. Disability was assessed with a questionnaire based on ICIDH and the Stanford Health Assessment Questionnaire. Handicap was measured using London Handicap Scale. Distributions of the proportions and 95% confidence intervals for disabilities, handicaps were calculated and stratified by dimensions, age and sex. The chi2 test was used for inter-group comparisons. RESULTS: Two hundred and fourteen patients were interviewed. Mobility-related and behaviour disabilities were most prevalent. Disability rose with age and was higher among women, except for behaviour disabilities which were more frequent in young men. Mean handicap score was 78.0 +/- 12.7. Handicap dimensions most affected were physical independence and economic self-sufficiency. CONCLUSIONS: The health profile of the population hardest hit by TOS is characterized by the presence of important functional and psychosocial disabilities that limit performance of daily living activities and social role, and are in accord with the handicap that such persons suffer.
Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Contaminação de Alimentos , Óleos de Plantas/intoxicação , Atividades Cotidianas , Adulto , Fatores Etários , Idoso , Brassica rapa , Estudos de Coortes , Transtornos da Comunicação/induzido quimicamente , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Transtornos Mentais/induzido quimicamente , Pessoa de Meia-Idade , Doenças Neuromusculares/induzido quimicamente , Estudos de Amostragem , Fatores Sexuais , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
INTRODUCTION AND OBJECTIVES: Toxic oil syndrome is an epidemic, multisystemic disease that appeared in Spain in 1981, and was caused by the consumption of rapeseed oil denatured with 2% aniline. The disease is similar to eosinophilia-myalgia syndrome. One of the cardiovascular disorders caused by this syndrome is pulmonary hypertension. We conducted a study to assess the validity of our indications for echocardiography in the follow-up of cardiovascular disorders in patients with this disease. PATIENTS AND METHOD: These patients are followed at our center with a standardized protocol for annual check-ups. From December 1997 through July 2002, a total of 1993 patients were examined. In this period we performed a total of 487 echocardiographic studies in 424 patients. The clinical records were reviewed to assess the indications for echocardiography according to the most recent guidelines for the clinical application of echocardiography of the American College of Cardiology and American Heart Association, and the indications were grouped into several categories. The diagnosis was recorded from the cardiologist's reports at the hospital where echocardiography was done. We calculated the sensitivity, specificity and positive likelihood ratio. RESULTS: 67% of the echocardiographic examinations were indicated to investigate possible pulmonary hypertension. About one-tenth of the studies (476 studies, 9.9%) led to a diagnosis of pulmonary hypertension. Sensitivity was highest (83%) for suspected pulmonary hypertension. Specificity was very high for most of the other indications. CONCLUSIONS: This study does not allow us to draw general conclusions about the cardiovascular disorders associated with toxic oil syndrome. However, echocardiography appears to be a good follow-up technique to diagnose complications such as pulmonary hypertension in these patients.
Assuntos
Brassica rapa , Doenças Cardiovasculares/diagnóstico por imagem , Óleos de Plantas/intoxicação , Ácidos Graxos Monoinsaturados , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Óleo de Brassica napus , Síndrome , UltrassonografiaRESUMO
AIM: This paper reports an investigation of the quality of life of patients most severely affected by toxic oil syndrome and the association between quality of life and disability variables, handicaps and depression. BACKGROUND: In 1981, an epidemic occurred in Central and Northwestern Spain. The illness, now called toxic oil syndrome (TOS), appeared to be caused by consumption of oil mixtures containing rapeseed oil denatured with aniline and affected over 20,000 individuals. Today, it is classified as a chronic disease that has resulted in a large number of sequelae. METHOD: From the 1031 people classified with permanent disability, a random sample of 292 individuals was selected. A structured interview was carried out to investigate the clinical aspects. The Nottingham Health Profile Questionnaire was used to assess quality of life. To study the relationship between quality of life and disability, handicap and depression, a univariate analysis was carried out. The chi-square test was used for inter-group comparisons. A P-value of 0.05 was adopted as the limit for inclusion of a variable in the multivariate analysis. Multivariate analysis was undertaken using logistic regression. RESULTS: Two hundred and fourteen patients were interviewed (79% response rate). Mean age was 59.3 (sd: 12.7) years. Quality of life mean score was 52.8 (sd: 22.6). The variables associated with poorer quality of life perception were depression [odds ratio (OR) = 9.66, confidence interval (CI) = 3.71-25.15], role-related disabilities (occupation role: OR = 2.82 CI = 1.28-6.22) and mobility (bending/picking up: OR = 4.74, CI = 2.31-9.72), as well as economic problems (OR = 1.62, CI = 1.07-2.46). CONCLUSION: The quality of life of those most severely affected by TOS is poor. Their health profile is characterized by depression and important functional and psycho-social disabilities that limit daily living activities and social roles, and are related to self-perceptions of poor quality of life.
Assuntos
Avaliação da Deficiência , Óleos de Plantas/intoxicação , Qualidade de Vida , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Depressão/epidemiologia , Depressão/etiologia , Surtos de Doenças , Emprego , Ácidos Graxos Monoinsaturados , Feminino , Contaminação de Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Dor/epidemiologia , Dor/etiologia , Óleo de Brassica napus , Distribuição por Sexo , Isolamento Social/psicologia , Espanha/epidemiologia , SíndromeRESUMO
OBJECTIVE: To ascertain whether carpal tunnel syndrome (CTS) in patients affected with toxic oil syndrome (TOS) is associated with conditions and diseases considered risk factors for CTS in the general population and/or with certain clinical manifestations of TOS. METHODS: We conducted a case-control study to compare 89 TOS patients residing in Madrid diagnosed with CTS from 1981 through July 2001 (cases) against 638 TOS patients not affected with CTS (controls). Risk factors for CTS and clinical manifestations of TOS were analyzed. RESULTS: Multivariate logistic regression analysis yielded the following odds ratios (95% confidence interval): 3.32 (1.47-7.50) for TOS-related neuropathy; 2.85 (1.14-7.13) for TOS-related thromboembolic events; 2.63 (1.36-5.06) for female gender; 0.43 (0.24-0.80) for TOS-related scleroderma; 0.26 (0.12 0.59) for smoking; and, in women, 2.53 (1.06-5.70) for fibrositis and 1.84 (1.04-3.20) for miscarriages. CONCLUSION: Our study findings support the hypothesis that CTS in TOS patients is more linked to certain clinical manifestations of TOS, mainly neuropathy, than to conditions and diseases considered risk factors for CTS in the general population.