12-YEAR FOLLOW-UP-STUDY OF EPIDEMIC SPANISH TOXIC OIL SYNDROME

Objective. To determine the longterm clinical and functional outcome a mong a large group of patients with toxic oil syndrome (TOS). Methods. One hundred individuals with onset in 1981 were randomly selected for followup in 1993 from a national TOS database. Clinical and laborator y data for 1981 were collected by retrospective chart review. Ninety-o ne survivors were reevaluated in 1993 by direct interview, examination , the Health Assessment Questionnaire (HAQ), and the visual analog sca le (VAS) for pain. A semiquantitative Total Clinical Score (TCS) was c reated to assess relative global outcome in 1993, for comparison with the HAQ, and for developing a predictive model based on disease manife stations at onset. Results. Fifty-eight percent continue to have sympt oms consisting predominantly of muscle cramping (60%), fatigue (55%), arthralgias (43%), subjective cognitive impairment (44%), psychiatric disease (27%), and soft tissue tenderness (22.5%). Severe neuromuscula r sequelae, sclerodermatous skin disease, or pulmonary hypertension we re not detected. The most notable laboratory findings at follow-up wer e hypercholesterolemia (55%) and hyperglycemia (14.5%). A good correla tion was demonstrated between both the HAQ and the VAS for pain with t he TCS. A statistical model indicated that alopecia, Raynaud's phenome non, and sensory neuropathy were predictive of outcome. Conclusion. TO S is commonly associated with longterm neuromuscular and articular dis ease. Multiple factors implicated in the adaptation to chronic disease may contribute to this morbidity.