TY - JOUR T1 - Short-term health effects in the general population following a major train accident with acrylonitrile in Belgium. JF - Environ Res Y1 - 2016 A1 - Simons, K A1 - De Smedt, T A1 - Stove, C A1 - De Paepe, P A1 - Bader, M A1 - Nemery, B A1 - Christiane Vleminckx A1 - Koen De Cremer A1 - Ilse Van Overmeire A1 - Sébastien Fierens A1 - Birgit Mertens A1 - Göen, T A1 - Schettgen, T A1 - Herman Van Oyen A1 - Joris Van Loco A1 - An Van Nieuwenhuyse KW - acrylonitrile KW - Adult KW - Belgium KW - Chemical Hazard Release KW - cotinine KW - Dose-Response Relationship, Drug KW - Environmental Monitoring KW - Female KW - Headache KW - Humans KW - Irritants KW - Male KW - middle aged KW - Nausea KW - Railroads KW - Self Report KW - SMOKING KW - Surveys and Questionnaires KW - Tremor KW - Valine AB -

BACKGROUND: Following a train derailment, several tons of acrylonitrile (ACN) exploded, inflamed and part of the ACN ended up in the sewage system of the village of Wetteren. More than 2000 residents living in the close vicinity of the accident and along the sewage system were evacuated. A human biomonitoring study of the adduct N-2-cyanoethylvaline (CEV) was carried out days 14-21 after the accident.

OBJECTIVES: (1) To describe the short-term health effects that were reported by the evacuated residents following the train accident, and (2) to explore the association between the CEV concentrations, extrapolated at the time of the accident, and the self-reported short-term health effects.

METHODS: Short-term health effects were reported in a questionnaire (n=191). An omnibus test of independence was used to investigate the association between the CEV concentrations and the symptoms. Dose-response relationships were quantified by Generalized Additive Models (GAMs).

RESULTS: The most frequently reported symptoms were local symptoms of irritation. In non-smokers, dose-dependency was observed between the CEV levels and the self-reporting of irritation (p=0.007) and nausea (p=0.007). Almost all non-smokers with CEV concentrations above 100pmol/g globin reported irritation symptoms. Both absence and presence of symptoms was reported by non-smokers with CEV concentrations below the reference value and up to 10 times the reference value. Residents who visited the emergency services reported more symptoms. This trend was seen for the whole range of CEV concentrations, and thus independently of the dose.

DISCUSSION AND CONCLUSION: The present study is one of the first to relate exposure levels to a chemical released during a chemical incident to short-term (self-reported) health effects. A dose-response relation was observed between the CEV concentrations and the reporting of short-term health effects in the non-smokers. Overall, the value of self-reported symptoms to assess exposure showed to be limited. The results of this study confirm that a critical view should be taken when considering self-reported health complaints and that ideally biomarkers are monitored to allow an objective assessment of exposure.

VL - 148 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27085497?dopt=Abstract M3 - 10.1016/j.envres.2016.03.031 ER -