Toxic oil syndrome mortality: the first 13 years

Background The toxic oil syndrome (TOS) epidemic that occurred in Spain in the spring of 1981 caused approximately 20 000 cases of a new illness. Overall mortality and mortality by cause in this cohort through 1994 are described for the first time in this report. Methods We contacted, via mail or telephone, almost every living member of the cohort and family members of those who were known to have died in order to identify all deaths from 1 May 1981 through 31 December 1994. Cause of death data were collected from death certificates and underlying causes of death were coded using the thtemational Classification of Diseases, 9th Revision. Results We identified 1663 deaths between 1 May 1981 and 31 December t994 among 19 754 TOS cohort members, for a crude mortality rate of 8.4%. Mortality was highest during 1981, with a standardized mortality ratio (SMR) of 4.92 (95% confidence interval [CI] 4. 39–5.50) compared with the Spanish population as a whole. The highest SMR, (20.41, 95% CI: 15.97–25.71) was seen among women aged 20–39 years during the period from 1 May 1981 through 31 December 1982. Women