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1 From the Department of Medicine, University of California, San Francisco
2 From Center for Occupational and Environmental Health, University of California, San Francisco
3 San Francisco State University
4 From California Environmental Protection Agency. Office of Environmental Health Hazard Assessment
5 From Center for Occupational and Environmental Health, University of California, San Francisco; and California Environmental Protection Agency. Office of Environmental Health Hazard Assessment
Study objective: To report the occurrence of persistent respiratory disorders, including irritant-induced asthma, among adults living and working near an environmental spill of the pesticide, metam sodium, after the derailment of a tank car.
Design: Retrospective clinical case series.
Setting: California communities situated within onehalf mile of the Sacramento River, from Mt. Shasta City to Shasta Lake.
Patients: 197 adults referred to a university occupational/environmental health clinic or to a private occupational/environmental health practitioner for evaluation of health problems potentially related to the spill.
Measurements and results: History, physical examination, review of medical records, spirometry, and methacholine challenge testing revealed 20 cases of persistent irritant-induced asthma and 10 cases of persistent exacerbation of astham.
Conclusions: This is the first reported series of cases of persistent irritant-induced asthma involving both community residents and occupationally exposed individuals.
Key Words: asthma • bronchial provation tests • isothiocyanates • methacholine challenge • thiocarbamates
Submitted on September 10, 1993
Accepted on January 6, 1994
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