title: Use of medication data to validate an association in community-based symptom prevalence studies.
abstract: A chemical spill from an oil refinery in Texas City, Texas, exposed the community to more than 40,000 lbs (18,144 kg) of highly toxic and corrosive hydrofluoric acid. A symptom prevalence study indicated an association between symptom reports, most notably breathing symptoms, and hydrofluoric acid exposure. Although verification of self-reported symptoms by checking medical records or performing clinical tests is theoretically possible, it is not a feasible alternative in dealing with an entire community. Open-ended data on medication use collected in the prevalence study were coded by organ system and analyzed by cross-classification techniques and log linear models. Results showed that the reported use of medication for hydrofluoric acid-related problems was associated with the exposure; medication use for problems unrelated to hydrofluoric acid exposure was uniform across the exposure categories. Moreover, medication use was significantly associated with the severity of breathing-related problems for each exposure category. Medication use, however, may have been under-reported because it seems difficult to conjure up the names of medications that were not taken or medications not taken recently may not be recalled. Nonetheless, open-ended medication data may be a useful surrogate approach to validating an association between an exposure and health outcomes.
authors.affiliation: University of Texas Medical Branch, Galveston, Texas.
authors.forename: H H
authors.initials: HH
authors.lastname: Dayal
authors.forename: Y H
authors.initials: YH
authors.lastname: Li
authors.forename: V
authors.initials: V
authors.lastname: Dayal
authors.forename: C K
authors.initials: CK
authors.lastname: Mittal
authors.forename: W
authors.initials: W
authors.lastname: Snodgrass
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D015984:Causality; D004363:Drug Utilization; D004781:Environmental Exposure; D006801:Humans; D006858:Hydrofluoric Acid / Q000009:adverse effects*; D016014:Linear Models; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D015203:Reproducibility of Results; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology*; D012720:Severity of Illness Index; D013781:Texas / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D006858:Hydrofluoric Acid