Bhopal tragedy's health effects: a review of methyl isocyanate toxicity

Article Abstract:

A leak of methyl isocyanate (MIC) from the Union Carbide pesticide plant in Bhopal, India killed or injured up to 200,000 people in December 1984. A review is presented of the medical literature concerning the effects of MIC exposure on the victims as well as its effects in laboratory studies. The two MIC storage tanks in Bhopal held 57,120 liters each; the allowable tank size in Europe, Japan, and the US was only 17,500 liters, with a maximum filling capacity of 50 percent. In Bhopal, water leaking into one of the tanks caused the release of approximately 24,545 kilograms of MIC and 12,800 kilograms of reaction products. The first deaths were reported less than three hours after the leak began (12:30 a.m.); by morning, more than 1,000 people had died. The acute effects of exposure to MIC were respiratory problems and eye irritation; people also suffered from circulatory, gastrointestinal, and central nervous system complications. Longer-term respiratory consequences included impaired pulmonary function (after three to four months) and the development of restrictive lung disease (involving reduced lung capacity) after six to eight months. Although the acute ophthalmic effects included severe watering of the eyes, sensitivity to light, lid swelling, and burning, longer-term damage does not seem to have occurred. Pregnant women exposed to the gas suffered a 43 percent miscarriage rate (normal incidence, between 6 and 10 percent). These effects are discussed in detail, as is the impact on children (which, unfortunately, has received little attention), and the immune system, neuromuscular system, blood and metabolism, and psychological health. Overall, most clinical studies carried out on this unfortunate group of people were not well-controlled and were purely observational; thus, causality can be difficult to determine. However, there is little doubt that this tragedy brings into painful focus the need for regulation of multinational corporations, both by their own countries and by the United Nations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Workplace accidents, Bhopal Union Carbide Plant Disaster, Bhopal, India, 1984, Methyl isocyanate

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Clinical prediction rules: a review and suggested modifications of methodological standards

Article Abstract:

Many clinical prediction rules do not meet proposed standards. Clinical prediction rules, which are also called clinical decision rules, are designed to help doctors make various decisions about patient care. Researchers analyzed 29 clinical prediction rules published in four general medical journals between 1991 and 1994. Many did not meet the standards proposed by one researcher in 1985. While 97% were clinically sensible, one-third were considered complicated. Additional standards for evaluating clinical prediction rules are discussed.

Standards, Decision-making, Decision making, Analysis, Medical literature

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Arterial puncture closing devices compared with standard manual compression after cardiac catheterization: systematic review and meta-analysis

Article Abstract:

Arterial puncture closing devices such as Angioseal, Duett, Perclose, Techstar, and Prostar may not be better than manual compression for treating the wound left when a cardiac patient has angioplasty, according to researchers who analyzed 30 studies of 4,000 patients. Angioplasty is used to open blocked arteries. During angioplasty, a catheter is inserted into a leg vein and pushed up toward the heart. This leaves a wound in the leg vein that must be healed.

Care and treatment, Injuries, Complications and side effects, Leg, Leg injuries, Cardiac patients, Cardiac catheterization, Heart catheterization

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