Abaitua Borda I, Philen R M, Posada de la Paz M, Gómez de la Cámara A, Díez Ruiz-Navarro M, Giménez Ribota O, Alvargonzález Soldevilla J, Terracini B, Severiano Peña S, Fuentes Leal C, Kilbourne E M
Instituto de Salud Carlos III, Centro de Investigación sobre el Síndrome del Aceite Tóxico, Ministerio de Sanidad y Consumo, Madrid, Spain.
Int J Epidemiol. 1998 Dec;27(6):1057-63. doi: 10.1093/ije/27.6.1057.
The toxic oil syndrome (TOS) epidemic that occurred in Spain in the spring of 1981 caused approximately 20000 cases of a new illness. Overall mortality and mortality by cause in this cohort through 1994 are described for the first time in this report.
We contacted, via mail or telephone, almost every living member of the cohort and family members of those who were known to have died in order to identify all deaths from 1 May 1981 through 31 December 1994. Cause of death data were collected from death certificates and underlying causes of death were coded using the International Classification of Diseases, 9th Revision.
We identified 1663 deaths between 1 May 1981 and 31 December 1994 among 19 754 TOS cohort members, for a crude mortality rate of 8.4%. Mortality was highest during 1981, with a standardized mortality ratio (SMR) of 4.92 (95% confidence interval [CI]: 4.39-5.50) compared with the Spanish population as a whole. The highest SMR, (20.41, 95% CI: 15.97-25.71) was seen among women aged 20-39 years during the period from 1 May 1981 through 31 December 1982. Women <40 years old, who were affected by TOS , were at greater risk for death in most time periods than their unaffected peers, while older women and men were not. Over the follow-up period, mortality of the cohort was less than expected when compared with mortality of the general Spanish population, or with mortality of the population of the 14 provinces where the epidemic occurred. We also found that, except for deaths attributed to external causes including TOS and deaths due to pulmonary hypertension, all causes of death were decreased in TOS patients compared to the Spanish population. The most frequent underlying causes of death were TOS, 350 (21.1%); circulatory disorders, 536 (32.3%); and malignancies, 310 (18.7%).
We conclude that while on average people affected by toxic oil syndrome are not at greater risk for death over the 13-year study period than any of the comparison groups, women <40 years old were at greater risk of death.
1981年春季在西班牙发生的有毒油综合征（TOS）疫情导致了约20000例新疾病病例。本报告首次描述了该队列人群截至1994年的总体死亡率及死因别死亡率。
我们通过邮件或电话联系了该队列中几乎所有在世成员以及已知死亡者的家庭成员，以确定1981年5月1日至1994年12月31日期间的所有死亡情况。从死亡证明中收集死因数据，并使用国际疾病分类第九版对根本死因进行编码。
我们在19754名TOS队列成员中确定了1981年5月1日至1994年12月31日期间的1663例死亡，粗死亡率为8.4%。1981年死亡率最高，与西班牙总人口相比，标准化死亡率（SMR）为4.92（95%置信区间[CI]：4.39 - 5.50）。1981年5月1日至1982年12月31日期间，20 - 39岁女性的SMR最高（20.41，95%CI：15.97 - 25.71）。受TOS影响的40岁以下女性在大多数时间段内比未受影响的同龄人死亡风险更高，而老年女性和男性则不然。在随访期间，与西班牙普通人群的死亡率或疫情发生的14个省份的人群死亡率相比，该队列的死亡率低于预期。我们还发现，除了归因于包括TOS在内的外部原因的死亡以及肺动脉高压导致的死亡外，TOS患者的所有死因死亡率均低于西班牙人群。最常见的根本死因是TOS，350例（21.1%）；循环系统疾病，536例（32.3%）；恶性肿瘤，310例（18.7%）。
我们得出结论，虽然在13年的研究期间，平均而言，有毒油综合征患者的死亡风险并不高于任何对照组，但40岁以下女性的死亡风险更高。
