Toxic oil syndrome: current knowledge and future perspectives
AbstractA collection of six state-of-the-art reviews summarizing current research on the epidemiology, etiology, pathogenesis, and clinical pathology of the toxic oil syndrome. Over 700 investigations, including numerous unpublished reports, were critically assessed. The explosive outbreak of the toxic oil syndrome, which occurred in Spain a decade ago, affected more than 20,000 persons, claimed more than 800 lives, and left many thousands more with permanent disability. Although contaminated rapeseed oil has been identified as the vehicle of the causative agent, the agent itself has not yet been identified and the mechanisms of pathogenicity remain unknown. Continuing research also responds to the need to find effective treatment for surviving victims and to monitor carcinogenic and other potential long-term effects on health. The first chapter reviews epidemiological findings from studies designed to determine the causal agent, the factors that influenced individual susceptibility, and the long-term evolution of disease manifestations. The second chapter presents the results of a systematic 31-month follow-up of the clinical status of patients. Problems discussed include the failure of all currently available treatments and the need to explain why disability is progressive in some patients, while others gradually improve. Other chapters summarize what has been learned, from autopsy studies and surgical specimens, about the pathology of the disease, present the results of various efforts to replicate the disease in experimental models, and summarize available data on the chemical composition of contaminated oils. The final chapter explores the involvement of immunological mechanisms in the disease, drawing direction from the similarity of symptoms to those seen in graft-versus host disease and in hydantoin-induced autoimmunity. In view of the many unresolved issues and gaps in understanding, the book concludes with an outline of further research needed, supported by guidelines for specific types of investigation.
World Health Organization. Regional Office for Europe. (1992). Toxic oil syndrome: current knowledge and future perspectives. World Health Organization. Regional Office for Europe. http://www.who.int/iris/handle/10665/260458
WHO regional publications. European series;42