A community-based epidemiologic study of health sequelae of exposure to hydrofluoric acid

Hari H. Dayal, Marilyn Brodwick, Ralph Morris, Thomas Baranowski, Norman Trieff, Joel A. Harrison, Jeffrey R. Lisse, G. A.S. Ansari

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


An accident at an oil refinery in Texas City, Texas, released around 40,000 lb of hydrogen fluoride, exposing the community to the highly toxic and corrosive substance. A population-based epidemiologic study was conducted to evaluate the impact of the accident on the health of the community. Exposure assessment was done using a multipronged approach through a door-to-door survey of 10, 811 individuals. A symptom survey resulting in 1994 completed interviews was conducted with a stratified random sample selected from the exposure study database. The sampling was balanced with respect to age, gender, and predisposition across the three ordinal exposure categories. The results show a strong dose relationship (P < 10-4) between the exposure and symptoms reported following the accident and 2 years later, most notably breathing and eye symptoms. However, substantial improvement in health was reported over the 2-year period regardless of the level of exposure. Problems of recall bias and behavioral sensitization are considered and it is recognized that the study may have overestimated the effect. It is also recognized that the study may not have completely unraveled the relative importance of exposure and host response in health outcome, since the two were probably conflated in the exposure measure. Nevertheless, the independence of predisposition and reported level of exposure, the magnitude of effect and its consistency, the unmistakable dose response, the large sample size, and the mutual corroboration of various findings make it difficult to dismiss the interpretation that the hydrofluoric acid exposure indeed caused health problems in the community that continued for at least 2 years after the accident.

Original languageEnglish (US)
Pages (from-to)213-230
Number of pages18
JournalAnnals of Epidemiology
Issue number3
StatePublished - May 1992


  • Community health
  • chemical spill
  • epidemiology
  • hydrofluoric acid
  • recall bias

ASJC Scopus subject areas

  • Epidemiology


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