Gema Rodríguez-Trigo, MD; Jan-Paul Zock, PhD; Francisco Pozo-Rodríguez, MD; Federico P. Gómez, MD; Gemma Monyarch, MSc; Laura Bouso, MSc; M. Dolors Coll, PhD; Héctor Verea, MD; Josep M. Antó, MD; Carme Fuster, PhD; Joan Albert Barberà, MD; for the SEPAR (Sociedad Española de Neumología y Cirugía Torácica)-Prestige Study Group
In 2002, the oil tanker Prestige spilled more than 67 000 tons of bunker oil, heavily contaminating the coast of northwestern Spain.
To assess respiratory effects and chromosomal damage in clean-up workers of the oil spill 2 years after the exposure.
Fishermen cooperatives in coastal villages.
Local fishermen who were highly exposed (n = 501) or not exposed (n = 177) to oil 2 years after the spill.
Respiratory symptoms; forced spirometry; methacholine challenge; markers of oxidative stress (8-isoprostane), airway inflammation (interleukins, tumor necrosis factor-α, and interferon-γ), and growth factor activity in exhaled breath condensate; and chromosomal lesions and structural alterations in circulating lymphocytes.
Compared with nonexposed participants, persons exposed to oil were at increased risk for lower respiratory tract symptoms (risk difference, 8.0 [95% CI, 1.1 to 14.8]). Lung function did not significantly differ between the groups. Among nonsmoking participants, exposed individuals had higher exhaled 8-isoprostane levels than nonexposed individuals (geometric mean ratio, 2.5 [CI, 1.7 to 3.7]), and exposed individuals with lower respiratory tract symptoms had higher 8-isoprostane levels than those of exposed individuals without symptoms. Exposed nonsmoking participants also had higher levels of exhaled vascular endothelial growth factor (risk difference, 44.8 [CI, 27.9 to 61.6]) and basic fibroblast growth factor (risk difference, 16.0 [CI, 3.5 to 28.6]). A higher proportion of exposed participants had structural chromosomal alterations (risk difference, 27.4 [CI, 10.0 to 44.8]), predominantly unbalanced alterations. The risk for elevated levels of exhaled 8-isoprostane, vascular endothelial growth factor, and basic fibroblast growth factor and structural chromosomal alterations seemed to increase with intensity of exposure to clean-up work.
The clinical significance of exhaled biomarkers and chromosomal findings are uncertain. The association between oil exposure and the observed changes may not be causal. The findings may not apply to spills involving other types of oil or to different populations of oil spill workers.
Participation in clean-up of a major oil spill was associated with persistent respiratory symptoms, elevated markers of airway injury in breath condensate, and chromosomal damage.
Instituto de Salud Carlos III.
Oil spills are ecological disasters, but their health effects on humans are not well known.
This study found that Spanish fishermen who participated in the clean-up of a coastal oil spill had a higher prevalence of respiratory symptoms, higher levels of markers suggestive of airway injury in exhaled breath condensate, and chromosomal alterations in lymphocytes than did those who did not participate in clean-up activities.
The clinical significance of the marker and chromosomal findings is not known. The study does not prove that oil exposure caused the abnormalities.
Participation in clean-up of a major oil spill seemed to have adverse health effects. The clinical significance of the findings is not known.
* Participated in clean-up activities for at least 15 days, for 4 or more hours per day on average, including November and December 2002.
† Did not participate in clean-up activities for non–health-related reasons.
‡ Met the inclusion criteria both at the questionnaire survey and at the face-to-face interview.
§ Participants reported never having smoked both at the questionnaire survey and at the face-to-face interview.
|| 8-Isoprostane was measured in all participants indicated; the numbers in brackets indicates those for whom additional analyses of cytokines and growth factors were done.
¶ Participants reported having children (which proved their fertility) and had no history of malignant neoplasms.
Appendix Table 1.
Bars indicate the geometric mean of the 8-isoprostane level. Lower respiratory tract symptoms were wheeze with breathlessness, wheeze apart from colds, nocturnal attacks of shortness of breath, chronic cough, or chronic phlegm.
Appendix Table 2.
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Rodríguez-Trigo G, Zock J, Pozo-Rodríguez F, Gómez FP, Monyarch G, Bouso L, et al. Health Changes in Fishermen 2 Years After Clean-up of the Prestige Oil Spill. Ann Intern Med. ;153:489–498. doi: 10.7326/0003-4819-153-8-201010190-00279
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Published: Ann Intern Med. 2010;153(8):489-498.
Hospital Medicine, Prevention/Screening, Pulmonary/Critical Care.
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