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IJE Advance Access originally published online on May 27, 2004
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International Journal of Epidemiology, Volume 33, Number 3, pp. 443-444
IJE vol.33 no.3 © International Epidemiological Association 2004; all rights reserved.

Editorial

The limits of epidemiology and the Spanish Toxic Oil Syndrome

Benedetto Terracini

University of Torino, Via Santena 7, 10126 Torino, Italy. E-mail: terracini@etabeta.it

The first 150 words of the full text of this article appear below.

The outbreak of the condition eventually called Toxic Oil Syndrome (TOS) in Madrid and north-western Spain in May 1981 was unique because of its size (20 000 affected, over 300 dying within a few months, a few thousand invalids), the novelty of the clinical condition, and the complexity of its aetiology. The illness is currently thought to be a multisystem disease initiated by a non-necrotizing endothelial injury, with a likely immune mechanism in its inception and/or evolution.1 Clinically, it started as a varying combination of fever, rash, lung and pleural effusions, myalgias, paresthesias, and eosinophilia: in a sizeable proportion of survivors it evolved to lung hypertension, cachexia, contractures, and scleroderma.

Shortly after the episode, a collaboration started between the Spanish Government and the European Office of the World Health Organization, leading to the creation of a Joint Scientific Committee (of which I have been a member since the mid-1980s), which . . . [Full Text of this Article]


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