title: Acute health effects after accidental exposure to styrene from drinking water in Spain.
abstract: OBJECTIVE
  We studied subjective health symptoms in a population accidentally exposed to high styrene concentrations in drinking tap water. The contamination occurred during the reparation of a water tank.
  
  
  METHODS
  Residents of 27 apartments in two buildings using the contaminated water were contacted. A questionnaire on subjective symptoms was administered to 84 out of 93 persons living in the apartments at the time of the accident. Styrene concentration was measured in samples of water collected two days after the accident. The means of exposure associated with appearance of symptoms were examined through case-control analyses.
  
  
  RESULTS
  Styrene in water reached concentrations up to 900 microg/L. Symptoms were reported by 46 persons (attack rate 55 %). The most frequent symptoms were irritation of the throat (26%), nose (19%), eyes (18%) and the skin (14%). General gastrointestinal symptoms were observed with 11% reporting abdominal pain and 7% diarrhea. The factors most strongly associated with symptoms were drinking tap water (OR = 7.8, 95% CI 1.3-48), exposure to vapors from the basement (OR = 10.4, 2.3-47) and eating foods prepared with tap water (OR = 8.6, 1.9-40). All residents in the ground floor reported symptoms.
  
  
  CONCLUSIONS
  This accidental contamination led to very high styrene concentrations in water and was related to a high prevalence of subjective symptoms of the eyes, respiratory tract and skin. Similar exposures have been described in workers but not in subjects exposed at their residence. Various gastrointestinal symptoms were also observed in this population probably due to a local irritative effect.
authors.affiliation: Centro de Salud Pública, Dirección Territorial de Salud, Castellón, Spain. alberto.arnedo@sanidad.m400.gva.es <alberto.arnedo@sanidad.m400.gva.es>
authors.forename: Alberto
authors.initials: A
authors.lastname: Arnedo-Pena
authors.forename: Juan
authors.initials: J
authors.lastname: Bellido-Blasco
authors.forename: Jose-Luis
authors.initials: JL
authors.lastname: Villamarin-Vazquez
authors.forename: Jose-Luis
authors.initials: JL
authors.lastname: Aranda-Mares
authors.forename: Nuria
authors.initials: N
authors.lastname: Font-Cardona
authors.forename: Fabriziomaria
authors.initials: F
authors.lastname: Gobba
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
mesh_terms: D000059:Accidents; D000208:Acute Disease / Q000145:classification / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000453:epidemiology; D006798:Housing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007509:Irritants / Q000633:toxicity; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000453:epidemiology; D012498:Sanitary Engineering; D012871:Skin Diseases / Q000139:chemically induced / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D020058:Styrene / Q000633:toxicity*; D011795:Surveys and Questionnaires; D014874:Water Pollutants, Chemical / Q000633:toxicity*; D014881:Water Supply / Q000032:analysis* / Q000592:standards
chemical_list: D007509:Irritants; D014874:Water Pollutants, Chemical; D020058:Styrene