title: Persistent respiratory health effects after a metam sodium pesticide spill.
abstract: OBJECTIVE
  To report the occurrence of persistent respiratory disorders, including irritant-induced asthma, among adults living and working near an environmental spill of the pesticide, metam sodium, after the derailment of a tank car.
  
  
  METHODS
  Retrospective clinical case series.
  
  
  METHODS
  California communities situated within one-half mile of the Sacramento River, from Mt. Shasta City to Shasta Lake.
  
  
  METHODS
  197 adults referred to a university occupational/environmental health clinic or to a private occupational/environmental health practitioner for evaluation of health problems potentially related to the spill.
  
  
  RESULTS
  History, physical examination, review of medical records, spirometry, and methacholine challenge testing revealed 20 cases of persistent irritant-induced asthma and 10 cases of persistent exacerbation of asthma.
  
  
  CONCLUSIONS
  This is the first reported series of cases of persistent irritant-induced asthma involving both community residents and occupationally exposed individuals.
authors.affiliation: Department of Medicine, University of California, San Francisco, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Cone
authors.forename: L
authors.initials: L
authors.lastname: Wugofski
authors.forename: J R
authors.initials: JR
authors.lastname: Balmes
authors.forename: R
authors.initials: R
authors.lastname: Das
authors.forename: R
authors.initials: R
authors.lastname: Bowler
authors.forename: G
authors.initials: G
authors.lastname: Alexeeff
authors.forename: D
authors.initials: D
authors.lastname: Shusterman
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced*; D004190:Disasters; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006540:Herbicides / Q000009:adverse effects; D006801:Humans; D017879:Isothiocyanates / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010575:Pesticides / Q000009:adverse effects*; D012189:Retrospective Studies; D013859:Thiocarbamates / Q000009:adverse effects*
chemical_list: D000393:Air Pollutants; D006540:Herbicides; D017879:Isothiocyanates; D010575:Pesticides; D013859:Thiocarbamates; C008435:methyldithiocarbamate; C005227:methyl isothiocyanate