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Short-term health effects in the general population following a major train accident with acrylonitrile in Belgium

(2016) ENVIRONMENTAL RESEARCH. 148. p.256-263
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Abstract
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 100 pmol/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.
Keywords
EXPOSURE ASSESSMENT, CHEMICAL INCIDENTS, RAT, MACROMOLECULES, METABOLISM, WORCESTER, COTININE, TOOL, Acrylonitrile, Human biomonitoring, Health effects, Sewage, General, population, Accident

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Citation

Please use this url to cite or link to this publication:

Chicago
Simons, K, T De Smedt, Christophe Stove, Peter De Paepe, M Bader, B Nemery, C Vleminckx, et al. 2016. “Short-term Health Effects in the General Population Following a Major Train Accident with Acrylonitrile in Belgium.” Environmental Research 148: 256–263.
APA
Simons, K., De Smedt, T., Stove, C., De Paepe, P., Bader, M., Nemery, B., Vleminckx, C., et al. (2016). Short-term health effects in the general population following a major train accident with acrylonitrile in Belgium. ENVIRONMENTAL RESEARCH, 148, 256–263.
Vancouver
1.
Simons K, De Smedt T, Stove C, De Paepe P, Bader M, Nemery B, et al. Short-term health effects in the general population following a major train accident with acrylonitrile in Belgium. ENVIRONMENTAL RESEARCH. 2016;148:256–63.
MLA
Simons, K, T De Smedt, Christophe Stove, et al. “Short-term Health Effects in the General Population Following a Major Train Accident with Acrylonitrile in Belgium.” ENVIRONMENTAL RESEARCH 148 (2016): 256–263. Print.
@article{8516557,
  abstract     = {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 100 pmol/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.},
  author       = {Simons, K and De Smedt, T and Stove, Christophe and De Paepe, Peter and Bader, M and Nemery, B and Vleminckx, C and De Cremer, K and Van Overmeire, I and Fierens, S and Mertens, B and Goeen, T and Schettgen, T and Van Oyen, H and Van Loco, J and Van Nieuwenhuyse, A},
  issn         = {0013-9351},
  journal      = {ENVIRONMENTAL RESEARCH},
  keyword      = {EXPOSURE ASSESSMENT,CHEMICAL INCIDENTS,RAT,MACROMOLECULES,METABOLISM,WORCESTER,COTININE,TOOL,Acrylonitrile,Human biomonitoring,Health effects,Sewage,General,population,Accident},
  language     = {eng},
  pages        = {256--263},
  title        = {Short-term health effects in the general population following a major train accident with acrylonitrile in Belgium},
  url          = {http://dx.doi.org/10.1016/j.envres.2016.03.031},
  volume       = {148},
  year         = {2016},
}

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