Study objective -A chemical spill from an oil refinery exposed the local community to more than 40 000 lb of highly toxic and corrosive hydrofluoric acid. A community based symptom prevalence study found an association between exposure and physical symptoms: the psychological impact ofthe disaster and its potential effect on the reporting ofphysical symptoms is examined here. Design -The study used a population based survey design consisting of two phases: phase I, the exposure phase, and, phase II, the symptom prevalence phase. Subjects -In phase I, information indicative of exposure was collected on 10 811 individuals in a door to door survey of a geographically defined area. In phase II, symptom prevalence information was gathered through in-person interviews with 2509 subjects selected from the phase I census in a sampling scheme that balanced across the exposure categories with regard to age, gender, and predispositior. (HF) is a highly irritating and corrosive substance because of its high solubility in water and the capability of concentrated HF solutions to absorb water with a release of heat. These properties mean that it can cause severe burns to the skin and eyes as well as pulmonary damage, which may not be painful or visible for several hours after the initial exposure.' Once absorbed, HF has some direct and indirect systemic toxic effects which occur as a result of the rise of the fluoride concentration in the blood (direct), and the concomitant lowering of calcium and magnesium in blood, skin, and other organs (indirect).
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