Toxic oil syndrome

Toxic oil syndrome
Classification and external resources
Specialty	rheumatology
ICD-10	M35.8
ICD-9-CM	710.5
DiseasesDB	32044
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Toxic oil syndrome or simply toxic syndrome (Spanish: síndrome del aceite tóxico or síndrome tóxico) is a musculoskeletal disease most famous for a 1981 outbreak in Spain which killed over 600 people and was likely caused by contaminated colza oil. Its first appearance was as a lung disease, with unusual features; though the symptoms initially resembled a lung infection, antibiotics were ineffective. The disease appeared to be restricted to certain geographical localities, and several members of a family could be affected, even while their neighbours had no symptoms. Following the acute phase, a range of other chronic symptoms was apparent.

The cause was traced to the consumption of colza oil that had been intended for industrial rather than food use. To discourage human consumption, the oil was denatured by the addition of aniline to make it smell and taste bad. It was then imported as cheap industrial oil by the company RAPSA at San Sebastián, handled by RAELCA, and illegally refined by ITH in Seville to remove the aniline, resulting in a palatable product that could then be illegally sold. It was sold as "olive oil" by street vendors at weekly street markets, and was used on salads and for cooking. The commonly accepted hypothesis states that toxic compounds derived during the refinement process were responsible.

Once the origin of the syndrome was realised, public health officials organized an exchange programme, whereby those who had bought the oil could exchange it for pure olive oil, thereby quickly ending the outbreak.

The conclusion of the Joint WHO/CISAT Scientific Committee for the Toxic Oil Syndrome from 2002, that oil was the cause for TOS, is based only on epidemiological evidence, since up to now, experimental studies performed in a variety of laboratory animals have failed to reproduce the symptoms of human TOS. None of the in vivo or in vitro studies performed with toxic-oil-specific components, such as fatty acid anilides, and esters of 3-(N-phenylamino)-1,2-propanediol (abbreviated as PAP), have provided evidence that these markers are causally involved in the pathogenesis of TOS.

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