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首页> 外文期刊>The New England journal of medicine >Mass psychogenic illness attributed to toxic exposure at a high school (see comments)
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Mass psychogenic illness attributed to toxic exposure at a high school (see comments)

机译：大量心理疾病是由于高中的毒物暴露引起的（请参阅评论）

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BACKGROUND AND METHODS: Mass psychogenic illness may be difficult to differentiate from illness caused by bioterrorism, rapidly spreading infection, or toxic substances. We investigated symptoms attributed to exposure to toxic gas at a high school in Tennessee. In November 1998, a teacher noticed a 'gasoline-like' smell in her classroom, and soon thereafter she had a headache, nausea, shortness of breath, and dizziness. The school was evacuated, and 80 students and 19 staff members went to the emergency room at the local hospital; 38 persons were hospitalized overnight. Five days later, after the school had reopened, another 71 persons went to the emergency room. An extensive investigation was performed by several government agencies. RESULTS: We were unable to find a medical or environmental explanation for the reported illnesses. The persons who reported symptoms on the first day came from 36 classrooms scattered throughout the school. The most frequent symptoms (in this group and the group of people who reported symptoms five days later) were headache, dizziness, nausea, and drowsiness. Blood and urine specimens showed no evidence of carbon monoxide, volatile organic compounds, pesticides, polychlorinated biphenyls, paraquat, or mercury. There was no evidence of toxic compounds in the environment. A questionnaire administered a month later showed that the reported symptoms were significantly associated with female sex, seeing another ill person, knowing that a classmate was ill, and reporting an unusual odor at the school. CONCLUSIONS: The illness attributed to toxic exposure had features of mass psychogenic illness - notably, widespread subjective symptoms thought to be associated with environmental exposure to a toxic substance in the absence of objective evidence of an environmental cause. Alleviation of the anxiety surrounding an episode of mass psychogenic illness requires prompt recognition and a detailed investigation.
机译：背景与方法：大规模心理疾病可能难以与生物恐怖主义，迅速传播的感染或有毒物质引起的疾病区分开。我们在田纳西州的一所高中调查了归因于有毒气体暴露的症状。 1998年11月，一位老师在教室里注意到一种“汽油样”的气味，此后不久她就出现了头痛，恶心，呼吸急促和头晕。学校被撤离，80名学生和19名工作人员前往当地医院的急诊室。一夜之间有38人住院。五天后，学校重新开放后，又有71人前往急诊室。几个政府机构进行了广泛的调查。结果：我们无法找到所报告疾病的医学或环境解释。第一天报告症状的人来自遍布学校的36个教室。最常见的症状（在该组和五天后报告症状的人群中）是头痛，头晕，恶心和嗜睡。血液和尿液样本均未发现一氧化碳，挥发性有机化合物，农药，多氯联苯，百草枯或汞的迹象。没有证据表明环境中有毒化合物。一个月后进行的问卷调查显示，所报告的症状与女性明显相关，又见了另一个病人，知道同学生病，并报告学校有异味。结论：由于接触毒物引起的疾病具有大规模精神疾病的特征-特别是，在缺乏客观原因的情况下，广泛的主观症状被认为与环境接触有毒物质有关。减轻围绕大规模精神病发作的焦虑感需要迅速认识并进行详细调查。

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