TABLE 5.5 Relationship Between Sarin Exposure and Symptoms 3 Years After the Matsumoto Incident

Symptoms

Victims (n = 167),a n (%)

Controls (n = 669),b n (%)

Odds Ratio (95% CI)

Current symptoms

 

No

121 (72.5)

633 (94.6)

6.68 (4.15–10.78)

Yes

46 (27.5)c

36 (5.4)

 

Fatigue

25 (15.0)c

22 (3.3)

5.18 (2.84–9.44)

Asthenia

14 (8.4)c

11 (1.6)

5.47 (2.44–12.29)

Shoulder stiffness

15 (9.0)d

25 (3.7)

2.54 (1.31–4.94)

Bad dreams

5 (3.0)

7 (1.0)

2.92 (0.92–9.32)

Insomnia

9 (5.4)e

15 (2.2)

2.48 (1.07-5.78)

Blurred vision

18 (10.8)c

13 (1.9)

6.10 (2.92–12.72)

Narrowing of visual field

6 (3.6)e

7 (1.0)

3.52 (1.17–10.63)

Asthenopia

40 (24.0)c

21 (3.1)

9.72 (5.54–17.04)

Difficulty in smoking

0 (0)

3 (0.4)

Husky voice

2 (1.2)

7 (1.0)

1.15 (0.24–5.57)

Slight fever

4 (2.4)e

2 (0.3)

8.18 (1.49–45.07)

Palpitation

5 (3.0)e

5 (0.7)

4.10 (1.17–14.33)

Headache

14 (8.4)d

7 (1.0)

8.65 (3.43–21.81)

NOTE: Values given in absolute number of patients reporting symptoms (percentages). CI = confidence interval.

aVictims are those who lived in the geographic area of the incident and had one or more symptoms immediately after.

bControls lived in the geographic area of the incident but did not have one or more symptoms immediately after.

cSignificant differences noted between victims and controls at: p < .001.

dSignificant differences noted between victims and controls at: p < .01.

eSignificant differences noted between victims and controls at: p < .05.

SOURCE: Adapted from Nakajima et al., 1999.

piratory arrest, or convulsions, two of whom died. Patients in the highly exposed group improved by the time of discharge except for symptoms related to sarin’s effects on the eyes—ocular pain, blurred vision, and visual darkness (Okumura et al., 1996; Ohbu et al., 1997). All but five patients were discharged from the hospital by the fifth day.

More than 20 percent of the hospital staff who treated victims developed acute cholinergic symptoms from secondary exposure (Nozaki et al., 1995; Ohbu et al., 1997). Although hospital staff quickly suspected sarin intoxication in patients, they did not take appropriate precautionary measures because they were first erroneously notified by the fire department that acetonitrile was the agent. Only hours later were they notified that sarin had been implicated by GC-MS (Okumura et al., 1998a,b). An organophosphorus anticholinesterase pre-



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